Oregon Rate Sheet

Value Rate/Factor Premium

Protection Class 2 1.00 $175.00

Dwelling Amount
X Increased Limits Factor 24.29 $4,076.63

Limits
A. Dwelling $2,710,000.00
B. Other Structures $271,000.00
C. Personal Property $1,355,000.00
D. Loss of Use $542,000.00
TIV $4,878,000.00

Surcharge
Number of Losses 0 0%
Central Station Fire Alarm None 0%
Central Station Buglar Alarm None 0%
Sprinkler System Yes ­2%
Built Year 1905 10%
Extended RC No 0%
Surcharge 0.98 ­$85.03

Fire Score Factor $0.00

Additional Coverages
Increased Cov C Option None $0.00
Replacement Cost Contents No $0.00
Personal Injury Coverage No $0.00
Special Computer Coverage No $0.00
Special Personal Property Coverage No $0.00
Identity Fraud Expense Coverage Excluded $0.00
Mechanical Breakdown No $0.00
Water Backup & Sump $0.00 $0.00
Total Additional Premium $0.00

Liability Coverages
Liability $100,000.00 0.00 $0.00
Medical Payments $1,000.00 0.00 $0.00
Ordinance & Law 10% 0.00 $0.00
Total­ Liability and Ordinance and Law Coverages $0.00

Premium Details
Total Premium $9,756.00
Adjusted Premium $0.00
Premium (Without Fees And Taxes) $9,756.00
Premium (With Fees And Taxes)
Premium (Without Fees And Taxes) $9,756.00
Inspection Fee $100.00
Stamping Fee $10.00
Policy Fee $100.00
Premium Tax $199.12
Fire Marshall Tax $29.87
Total (Fees And Taxes) $10,194.99