State Farm Lloyds

A Lloyds Company In Richardson, Texas

PO Box 853907
Richardson, TX 75085-3907

AT2 H-08-1439-FA36 F H 4
PARAJULI, BIKASH & BARAL,
3200 RENEWAL DECLARATIONS
SRIJANA
1001 FULLER WISER RD APT 1325
EULESS TX 76039-8219
AMOUNT DUE: enoN
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Payment is due by BILLED THROUGH SFPP ____
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Policy Number: 72-E1-Y766-9

Policy Period: 12 Months

Effective Dates: FEB 15 2022 to FEB 15 2023
The policy period begins and ends at 12:01 am standard
time at the residence premises.

Renters Policy Your State Farm Agent

TJ VILLARREAL
Location of Residence Premises 3705 W GREEN OAKS BLVD STE A
1001 FULLER WISER RD APT 1325 ARLINGTON TX 76016-3327
EULESS TX 76039-8219

3200 08
Phone: (817) 461-0000

Automatic Renewal

003705 H
If the POLICY PERIOD is shown as 12 MONTHS, this policy will be renewed automatically subject to the premiums, rules,
and forms in effect for each succeeding policy period. If this policy is terminated, we will give you and the Mortgagee/Lien-

20
holder written notice in compliance with the policy provisions or as required by law.
IMPORTANT MESSAGES
NOTICE: Information concerning changes in your coverage is included. Please call your agent if you have any questions.
THIS POLICY CONTAINS A POLLUTION EXCLUSION (INCLUDING BUT NOT LIMITED TO ASBESTOS AND LEAD) LOCATED
UNDER SECTION II - EXCLUSIONS.
The Inflation Coverage provision may change your deductible. Refer to page 11 of your policy.
PREMIUM
Annual Premium 00.321$
Your premium has already been adjusted by the following:
Home/Auto Discount Claim Record Discount
Loyal Customer

Total Premium 00.321$

Prepared DEC 27 2021 Page 1 of 4

 NAMED INSURED MORTGAGEE AND ADDITIONAL INTERESTS
PARAJULI, BIKASH & BARAL,
SRIJANA
HUNT CLUB/ADARA COMMUNITIES Loan Number:
PO BOX 680005 N/A
HOUSTON TX 77268-0005

SECTION I - PROPERTY COVERAGES AND LIMITS

Coverage Limit of Liability
B Personal Property $ 007,12
C Loss of Use $ 086,8
Additional Coverages
Arson Reward 000,1$
Credit Card, Bank Fund Transfer Card, Forgery, and Counterfeit Money 000,1$
Debris Removal elbaliava %5 lanoitiddA
Fuel Oil Release 000,01$
Locks and Remote Devices 000,1$
Trees, Shrubs, and Landscaping meti rep 057$/tnuoma B egarevoC fo %01
SECTION II - LIABILITY COVERAGES AND LIMITS

DEC 27 2021
Coverage Limit of Liability
L Personal Liability (Each Occurrence) $ 000,001
Damage to the Property of Others $ 000,1
M Medical Payments to Others (Each Person) $ 000,1
INFLATION
Inflation Coverage Index: 276.6
o1F1081A

DEDUCTIBLES
Section I Deductible Deductible Amount
All Losses $ 005
LOSS SETTLEMENT PROVISIONS
B1 Limited Replacement Cost - Coverage B
 72-E1-Y766-9
FORMS, OPTIONS, AND ENDORSEMENTS
H4-2143 Renters Policy
HO-2333.1 *Amendatory Endorsement
*New Form Attached
ADDITIONAL MESSAGES
State Farm® works hard to offer you the best combination of price, service, and protection. The amount you pay for
homeowners insurance is determined by many factors such as the coverages you have, the type of construction, the
likelihood of future claims, and information from consumers reports.

Other limits and exclusions may apply - refer to your policy

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Prepared DEC 27 2021 Page 3 of 4

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DEC 27 2021
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(CONTINUED)
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 72-E1-Y766-9 026398

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