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    State Farm Proof of Insurance PDF

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    Anonymous RZZiNul
    This document is a homeowner's insurance policy declaration for Robert W Kurzdorfer. It provides coverage from 10/31/2016 to 10/31/2017 for property located at 268 Heather Hill Dr, West Seneca, NY 14224. The policy covers $232,000 for the dwelling and $174,000 for personal property with a $300,000 personal liability limit. The premium is $545 and the policy will automatically renew annually unless terminated with written notice. NBKC BANK is listed as the mortgagee.

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    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    State Farm Proof of Insurance PDF

    Uploaded by

    Anonymous RZZiNul
    650 views1 page
    This document is a homeowner's insurance policy declaration for Robert W Kurzdorfer. It provides coverage from 10/31/2016 to 10/31/2017 for property located at 268 Heather Hill Dr, West Seneca, NY 14224. The policy covers $232,000 for the dwelling and $174,000 for personal property with a $300,000 personal liability limit. The premium is $545 and the policy will automatically renew annually unless terminated with written notice. NBKC BANK is listed as the mortgagee.

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    State Farm Proof of Insurance.pdf

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    This document is a homeowner's insurance policy declaration for Robert W Kurzdorfer. It provides coverage from 10/31/2016 to 10/31/2017 for property located at 268 Heather Hill Dr, West Seneca, NY 14224. The policy covers $232,000 for the dwelling and $174,000 for personal property with a $300,000 personal liability limit. The premium is $545 and the policy will automatically renew annually unless terminated with written notice. NBKC BANK is listed as the mortgagee.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    650 views1 page

    State Farm Proof of Insurance PDF

    Uploaded by

    Anonymous RZZiNul
    This document is a homeowner's insurance policy declaration for Robert W Kurzdorfer. It provides coverage from 10/31/2016 to 10/31/2017 for property located at 268 Heather Hill Dr, West Seneca, NY 14224. The policy covers $232,000 for the dwelling and $174,000 for personal property with a $300,000 personal liability limit. The premium is $545 and the policy will automatically renew annually unless terminated with written notice. NBKC BANK is listed as the mortgagee.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 1

    DECLARATIONS

    We will provide the insurance described in this policy


    in return for the premium and compliance with all
    applicable provisions of this policy.
    32-B9-G648-2

    Coverage afforded by this policy is provided by:


    State Farm Fire and Casualty Company
    100 State Farm Place
    Ballston Spa, NY 12020-3722
    A Stock Company with Home Offices in Bloomington,
    Illinois.

    Policy Number

    Named Insured and Mailing Address


    Kurzdorfer, Robert W
    268 Heather Hill Dr
    West Seneca, NY 14224-4706
    The Policy Period begins and ends at 12:01 a.m.
    Standard Time at the residence premises.
    10/31/2016
    Effective Date
    12 months - Policy Period
    10/31/2017
    Expiration of Policy Period
    Limit of Liability - Section 1
    $232,000
    Dwelling
    $174,000
    Personal Property (Minimum 75% of
    Dwelling)
    Limit of Liability - Section 2
    $300,000
    Personal Liability
    $1,000
    Medical Payments to Others
    Policy Type
    Homeowners
    A1 - Replacement Cost - Similar Construction
    Increased Dwelling Up to $46,400 - Option ID

    Automatic Renewal - If the Policy Period is shown as


    12 months, this policy will be renewed automatically
    subject to the premiums, rules and forms in effect each
    succeeding policy period. If this policy is terminated, we
    will give you and the Mortgagee/Lienholder written
    notice in compliance with the policy provisions or as
    required by law.
    Deductibles - Section 1 1/2% $1,160
    ALL LOSSES In case of loss under this policy, the
    deductible will be applied per occurrence and will be
    deducted from the amount of the loss. Other deductibles
    may apply - refer to your policy.
    Earthquake:
    Policy Premium

    $545

    Location of Premises
    268 Heather Hill Dr
    West Seneca, NY 14224-4706
    Forms, Options, & Endorsements
    FP-7955.NY Homeowners Policy
    Amendatory Endorsement
    Back-Up Dwell/Listed Property
    Mortgagee & Addl. Interests
    Mortgagee
    NBKC BANK ISAOA
    10700 Nall Ave Ste 300
    Overland Park, KS 66211-1299
    Loan Number: 16057081

    Prepared: 11-28-2016
    559-916.5

    Homeowners Policy Endorsement


    Fungus Coverage Limitation
    Agent Name & Address
    Joe Czaja
    1021 Union Rd
    West Seneca, NY 14224-3401
    (716) 674-3654

    Agent's Code:2020
    APPLICANT COPY

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