Insurance Renters Policy

INSURANCE RENTERS POLICY

Policy Declarations

Policy Information

Policy Number:    Producer:

Policy Period: Effective Date through Expiration Date

Coverages and Limits

Personal Property Coverage — Limit: $   Deductible: $

Replacement Cost Option for Personal Property (if checked, ACV not applied)

Scheduled Personal Property — Items and values must be listed below

Personal Liability Coverage — Limit: $

Medical Payments to Others — Limit: $

Additional Living Expenses / Loss of Use — Limit: $

Loss Assessment Coverage — Limit: $

Ordinance or Law Endorsement

Earthquake Coverage Endorsement

Flood Coverage Endorsement (must be specifically endorsed)

Premiums and Fees

Exclusions

This policy does not provide coverage for intentional acts, wear and tear, mechanical breakdown, war, nuclear hazard, or loss caused by the discharge of contaminants unless specifically endorsed. Coverage for flood and earthquake is not included unless an appropriate endorsement or separate policy is issued. Coverage for motor vehicles, property lawfully rented to others for business purposes, and business property subject to separate commercial policy are excluded except as may be specifically described in an endorsement.

Duties in the Event of Loss / Claims

In the event of loss or damage, the insured must: provide written notice to the insurer or its authorized representative; take reasonable steps to protect property from further damage; provide proof of loss, inventories of damaged or lost property with values and supporting documentation; promptly provide any requested records or examinations under oath; and cooperate with investigation and subrogation efforts. Failure to comply with the Duties in the Event of Loss may result in denial of coverage to the extent such failure prejudices the insurer's investigation or defenses.

Police report (if theft or vandalism)

Photographs of damage

Receipts or proof of ownership

Repair or replacement estimates

Subrogation, Assignment and Cancellation

By accepting this policy the insured grants the insurer the right of subrogation against any third party responsible for loss to the extent of indemnity paid under this policy. Assignment of this policy or interest under it is not valid without the prior written consent of the insurer. This policy may be canceled or nonrenewed in accordance with the terms set forth in the policy conditions; refund of premium, if any, shall be made in accordance with those terms.

Beneficiary Designation for Policy Proceeds (if applicable)

If the insured elects to designate a beneficiary for certain settlement proceeds, provide name, relationship and allocation below. Such designation applies only to proceeds specifically payable to a beneficiary under the terms of the policy and does not alter ownership of insured property.

Declarations and Certification

I certify that the information provided in this policy and any attachments is true and complete to the best of my knowledge. I understand that any material misrepresentation, omission or concealment of facts may be grounds for denial of coverage or rescission of the policy. I authorize the insurer to obtain such information as may be necessary to underwrite, administer and investigate claims under this policy, including employment and credit information where permitted by law. I agree to pay premiums when due and that coverage is effective only when premiums are paid and the insurer has issued confirmation of coverage as required by policy terms.

This document constitutes the policy jacket and declarations page; specific terms, conditions, endorsements and limitations are contained in the policy provisions and any attached endorsements. Coverage is subject to all terms, conditions, limitations, and exclusions contained in the policy.

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