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Renters Policy#: OH 1696272
A Liberty Mutual Company
Customer Information
ANGELA A GOSSWILLER
28728 Green River Rd
KENT, WA 98030-8300
Date Prepared: 04/22/2016
Policy Period: 04/15/2016 to 04/15/2017
Changes Effective: 04/22/2016
DWELLING LOCATION
28728 Green River Rd
KENT, WA 98030-9300
PRIMARY COVERAGES
Agent Information
GRIFFIN MAC LEAN INC
2340 130TH AVE NE D150
BELLEVUE, WA 98005-1755
Phone Number: (425) 822-1368
Email: tara@griffinmaclean.com
Website: www.griffinmaclean.com
Agent #: 025606
Personal Property
Loss of Use
Personal Liability
Medical Payments
$37,100
1 12 Months
$300,000
1 $1,000
DEDUCTIBLES
Amount
All.Perils Deductible
$1,000.00
PREMIUM SUMMARY
Premium
Primary Coverages
$317.00
Other and Optional Coverages
Included
Discounts and Surcharges
-$60.00
Your total policy premium for 12 months is
$257.00
This is not a contract but confirms that the coverages displayed are in effect.
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Safeco Insurance Company of America
Insurance,M
A Liberty Mutual Company
OTHER AND OPTIONAL COVERAGES
Full Value on Personal Property
Total
DISCOUNTS AND SURCHARGES
Account Credit
Renewal Credit
Total
Renters Policy#: OH1696272
Coverages: Insurance is afforded only for such coverages as are indicated by specific premium charges.
Safeco Insurance Company of America
Limit
Premium
Included
Included
Premium
-$45.00
-$15.00
-$60.00
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