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Evidence of Insurance for Mortgagee/Other Interests FARMERS`
This form is not the contract of insurance. It is a memorandum of coverage limited to mortgagee/other interests, provided at their request and
applicable to the dwelling or building at the location below. The provisions of the policy will prevail in all respects. This certificate of
insurance does not affirmatively or negatively amend, extend, or alter the coverage afforded by the insurance policy. Should the insurance
policy be cancelled by the company before the expiration date thereof, notice will be given in accordance with the policy provisions.
Insured Information
Named Insured
SHAENA SPEIDEL
Mailing Address
3224 V ST SE
AUBURN WA 98002-8227
Property Address
3224 V ST SE
AUBURN WA 98002-8227
Policy Information
Policy Number 976113690
Company Name FARMERS INSURANCE COMPANY OF
TTTA CSTT Tfl'rf11.T
Policy Type RENTERS
Policy Status IN FORCE
Policy Term Effective Date
Renewal Date
Annual Premium
Balance Due
First Mortgagee
05/02/2014
05/02/2015
213.88
On Scheduled Pay Plan
Second Mortgagee/Other Interest
CITY OF AUBURN
25 W MAIN ST
AUBURN WA 98001-4916
MortTagee Deductible Clause
Not pplicable
438BFUNS Endorsement Included Y
Agent Information
Name
CINDY J HENSON
Address
132 E MAIN ST
AUBURN WA 98002-5411
Phone
253-735-9217 Fax 253-735-4042
Email
chensonl@fannersagent.com
Coverage Information
Coverage Limit
Dwelling
Extended Replacement Cost NONE
Personal Property $10,000
Personal Liability $500,000
Deductible applicable to each covered loss:
$500
Loss Of Use $2,000
Loan Number Who Pays
Mortgagee Effective Date
Loan Number
Other Interest Effective Date 10/06/2014
President
*- D51�
25-2960 4-12 Print Date: 10/06/2014
Authorized Farmers Representative