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- Summary of Loss Page 1 of 2 <br /> • <br /> Sl7eN. Summary of Loss <br /> Named Insured: Peggy Jeffery Claim Number: 37-03P0-26W <br /> Coverage A-Dwelling Linn of Lability:5 203,609.00 <br /> D escription: RM anti: Res Dep$: sones Dept Mx a«Simla: Subtolatc <br /> O oarup-hMmn Carpentry(See $ 0,00 $ 0.00 $ 0.00 $ 000 $ 0.03 <br /> Option 10) <br /> Repairs-Stam Farm estimate $ 20380900 $ 000 0.00 $ 0.00 $ 203.809.00Asbestos Abatement.SeeOpt 10 $ 4850.00 $ 0.00 $ 000 $ 4,850.80 $ 080 <br /> Supplemental dumpetee $ 2,040.08 $ 0.00 $ 0.00 S 2,040.08 $ 080 <br /> ($4740.0es2700) <br /> Table): $ 210,490.09 $ 0.00 $ 0.00 $ 5.$90.05 $ 203,609,00 <br /> animus) <br /> Coverage B -Personal Property Lima mliability$ 152,707.03 <br /> IMcrpeon: Req Cosa: Rec1340$: Hmacc Oep$: Amt Oyer Lim03: Subbbe: <br /> Textile Cleaning-CRON Si 5.599.74 $ 0.00 $ 0.00 $ 0.00 $ 5,590.74 <br /> Advance Paymenis $ 18.072,70 5 000 $ 0.00 $ 0.00 1 18,072.70 <br /> Contents cleaning-ServH° $ 284989 $ 0.00 5 000 5 0.00 $ 2,849.89 <br /> Teaks): S *522.33 5 0.0 $ 0.00 $ 0.00 5 29522.33 <br /> Comments: <br /> Coverage C - Loss of Use Linn of Liability:5 61.083.00 <br /> �/ p,ca Total: Amt Over Lena: Subtotal: <br /> 'F Hotel 12/18-1 $ 500.88 $ 000 $ 500.88 <br /> Hotel 12/21-12/31 $ 1,023.80 $ 0.00 1 1,023.00 <br /> Insured and dog bdpmg 12/31-1/21.22 days $ 880.00 $ 0.00 $ 850.00 <br /> e$4aday <br /> D og care,12)22-12/31,10 days a$30/ay s 380.00 $ 000 $ 300.00 <br /> Temp Housing-Fees(App,Cln,Pet) $ 1250.00 $ 000 $ 1250.00 <br /> Temp Housing 01/21-04730 5 0702.83 $ 0.00 $ 8,70283 <br /> Tenp Housing 0501-0930 $ 12,030.00 $ 0.00 $ 12,93000 <br /> Towl.l: $ 25.58749 $ 0.00 $ 23,557.49 <br /> Comments: <br /> Optional Policy Provisions: <br /> Description: Limn of Lieb$: Rry1 Cosa: Roc bp$: fonds sept: Amt Over Simla: Subtotal) <br /> Option l0- $ 40,721.80 $ 14,591.74 $ 0.00 $ 003 $ 000 5 14,59174 <br /> Inoeaased Dwelling <br /> Tons,shrubs, $ 10,19045 $ 285.12 $ 0.00 $ 0.00 $ 0.00 $ 28532 <br /> Plants <br /> TWlls): $ 14,81539 $ 0.00 $ 0.00 $ 0.00 5 14.585.85 <br /> Comments'. <br /> Board-up end reams over Ccv A limn <br /> Payments Made <br /> Mbe <br /> : Dcdpdon: Amount: <br /> �y <br /> T `2/152019., Coy B-Advan® $ 2500.09 <br /> 'e FiYc oto,..... & $ylo,-R.- III I 2 Yrs <br /> http://sfeuc.oprstatefarm.org/EUCNET00499N2/Pages/AIIStatesExceptNC.aspx?us= 4/7/2020 <br />