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State Farm <br /> BANKS,DALE 37-11L8-13H <br /> Insured: BANKS,DALE Estimate: 37-11L8-13H <br /> Property: 23305 SALMONBERRY LN Claim Number: 371 IL813H <br /> LYONS,OR 97358-9426 Policy Number. 37BRL5310 <br /> Home: 503-859-2033 Price List: ORCR28_SEP20 <br /> Cellular: 503-586-8539 Restoration/Service/Remodel <br /> Type of Loss: Fire <br /> Deductible: S1,000.00 <br /> Date of Loss: 9/8/2020 <br /> Date Inspected: 10/1/2020 <br /> Summary for Coverage A-Dwelling Extension-33 Fire,Lightning,& <br /> Removal <br /> Line Item Total 14,219.32 <br /> Replacement Cost Value 14,219.32 <br /> Less Depreciation(Including Taxes) (1,351.17) <br /> Less Deductible (1,000.00) <br /> Less Amount Over Limit(s) (6,868.15) <br /> Net Actual Cash Value Payment $5,000.00 <br /> Maximum Additional Amounts Available If Incurred: <br /> Total Line Item Depreciation(Including Taxes) 1,351.17 <br /> Replacement Cost Benefits 1,351.17 <br /> Less Amount Over Limit(s) (1,351.17) <br /> Total Maximum Additional Amount Available If Incurred 0.00 <br /> Total Amount of Claim If Incurred $5,000.00 <br /> ,MIMS <br /> 866-787-8676 x 11864 <br /> Moyer Lawrence <br /> ALL AMOUNTS PAYABLE ARE SUBJECT TO THE TERMS,CONDITIONS AND <br /> LIMITS OF YOUR POLICY. <br /> Date: 101-20=: :_ =: =`.; 3 <br /> Paee: <br />