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Evidence of Insurance - 2021-11-17 - 15555 Millard Ave, Markham, IL 60428.pdf

Generated 2026-07-01T05:25:50.520233+00:00 from live Dropbox Public folders.

Description

Wed Nov 17 15:29:08 CST 2021 Shelter Mutual Insurance Company 1817 W Broadway Columbia, MO 65218 1-800-SHELTER (743-5837) Dwelling Insurance Policy Evidence Of Insurance As Of 11/17/2021 Policy Number: Effective Date: Expiration Date: Named Insured: LOFTY HOLDING 15555 MILLARD AVENUE LLC 11718 FOLKSTONE LN LOS ANGELES, CA 90077-1310 Agent: 12-73-10784513-38 11/17/2021 (3:16 PM CST) 11/17/2022 (12:01 AM CST) LUKE ROTH 34-AB19-85 2245 W DUBLIN GRANVILLE RD WORTHINGTON, OH 43085-3336 (614) 832-7949

Extracted Content

Wed Nov 17 15:29:08 CST 2021 Shelter Mutual Insurance Company 1817 W Broadway Columbia, MO 65218 1-800-SHELTER (743-5837) Dwelling Insurance Policy Evidence Of Insurance As Of 11/17/2021 Policy Number: Effective Date: Expiration Date: Named Insured: LOFTY HOLDING 15555 MILLARD AVENUE LLC 11718 FOLKSTONE LN LOS ANGELES, CA 90077-1310 Agent: 12-73-10784513-38 11/17/2021 (3:16 PM CST) 11/17/2022 (12:01 AM CST) LUKE ROTH 34-AB19-85 2245 W DUBLIN GRANVILLE RD WORTHINGTON, OH 43085-3336 (614) 832-7949 Policy Deductible $1,000 Described Premises 15555 MILLARD AVE MARKHAM, IL 60428 Description FRAME, NON-OWNER, 1 FAMILY DWELLING, W/ MINE SUBSIDENCE Coverages Limits Dwelling Frame, W/ Mine Subsidence Addition of the Peril of Vandalism Mine Subsidence Coverage Endorsement Loss of Rents Additional Living Expense Drainage System Endorsement Endorsement Number $137,500 $10,000 $621.00 $42.00 B-847.2-B B-313.17-B $13,750 $13,750 $10,000 B-102.7-B Total for Term (This is Not a Bill): Policy forms and additional endorsements attached to this policy Loss of Rents Additional Living Expense Landlords Liability Coverage and Medical Payments Coverage 1000 Policy Term: 12 months Zone Code: 001 Premium $