Personal Homeowners Proposal

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Present Coverage

Proposed Coverage

Dwelling Limit

Dwelling Replacement Cost Guarantee Included?

Contents (Unscheduled) Limit

Contents Replacement Cost Provision Included?

Scheduled Property Limit

Extended Theft Coverage on Contents Included?

Detached Building(s) Limit

Property Deductible Amount

Loss of Use Limit

Personal Liability Limit

Personal Injury Liability Included?

Medical Payment Amount

Insurance Company

Options

Remarks

Premium

Option 1

Option 2

Total Premium, Including Options

Premium Payment Options


Jack Fries can be reached at Fries & Fries Consulting, 907 Stewart Place, Morgantown, WV 26505, (304) 598-2995, fax (304) 598-3245, email [email protected], or Web site www.jackfries.com.
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