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Evidence of Property - MidPen Housing Corporation
ACORDTM, EVIDENCE OF COMMERCIAL PROPERTY INSURANCE DATE (MM/DD/YYYY) 12/16/2014 THIS EVIDENCE OF COMMERCIAL PROPERTY INSURANCE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE ADDITIONAL INTEREST NAMED BELOW. THIS EVIDENCE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS EVIDENCE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE ADDITIONAL INTEREST. PRODUCER NAME, PHONE 303-534-4567 COMPANY NAME AND ADDRESS NAIC NO: 19437 CONTACT PERSON AND ADDRESS A/C, No, Ext : IMA, Inc. — Colorado Division Lexington Insurance Company 1705 17`h Street, Suite 100 Denver, CO 80202 FAX 303-534-0600 E-MAADDRESS: denpam@imacorp.com A/C, No : IF MULTIPLE COMPANIES, COMPLETE SEPARATE FORM FOR EACH CODE: SUB CODE: 107 POLICY TYPE Commercial Property Policy AGENCY 34403 CUSTOMER ID #: NAMED INSURED AND ADDRESS LOAN NUMBER POLICY NUMBER Mid Pen Housing Corporation 114633702015N EFFECTIVE DATE EXPIRATION DATE ❑ CONTINUED UNTIL 303 Vintage Park Drive, Suite 250 Foster City, CA 94404 01/01/2015 01/01/2( TERMINATED IF CHECKED ADDITIONAL NAMED INSURED(S) THIS REPLACES PRIOR EVIDENCE DATED: 'KUrt:K I T IIVrUKIVIA I IUIV IUse KCIVIAKI\J on rage L, IT more space Is requirea) IZSI t5UILUlrvl7 UK LJ t9UJIIVtJJ rtKJUNAL rKUF'tK 17 LOCATION/DESCRIPTION 989 Sharmon Palms Lane, Campbell, CA 95008 THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS EVIDENCE OF PROPERTY INSURANCE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. COVERAGE INFORMATION PERILS INSURED ❑ BASIC ❑ BROAD ❑ SPECIAL M COMMERCIAL PROPERTY COVERAGE AMOUNT OF INSURANCE $125,000,000 Loss Limit DED: $5,000 YES NO N/A ® BUSINESS INCOME ® RENTAL VALUE If YES, LIMIT: See Remarks ® Actual Loss Sustained, # of months 12 BLANKET COVERAGE X If YES, indicate value(s) reported on property identified above. $ TERRORISM COVERAGE X Attach Disclosure Notice / DEC IS THERE A TERRORISM -SPECIFIC EXCLUSION? X IS DOMESTIC TERRORISM EXCLUDED? X LIMITED FUNGUS COVERAGE X If YES, LIMIT: See Remarks DED: $5,000 FUNGUS EXCLUSION (IF "YES,' specify organization's form used) X REPLACEMENT COST X AGREED VALUE X COINSURANCE X If Yes, % EQUIPMENT BREAKDOWN (If Applicable) X If YES, LIMIT Incl. in loss limit DED: $5,000 ORDINANCE OR LAW — Coverage for loss to undamaged portion of bldg X — Demolition Costs X If YES, LIMIT: See Remarks DED: $5,000 — Incr. Cost of Construction X If YES, LIMIT: See Remarks DED $5,000 EARTH MOVEMENT (If Applicable) X If YES, LIMIT: See Remarks DED: See Remarks FLOOD (If Applicable) X If YES, LIMIT See Remarks DED See Remarks WIND/HAIL (If Subject to Different Provisions) X If YES, LIMIT: Incl. in loss limit DED $5,000 PERMISSION TO WAIVE SUBROGATION IN FAVOR OF MORTGAGE HOLDER PRIOR TO LOSS X CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. ADDITIONAL INTEREST MORTGAGEE X LENDERS LOSS PAYABLE NAME AND ADDRESS The City of Campbell 70 North First Street Campbell, CA 95008 ADDITIONAL INSURED I LENDER SERVICING AGENT NAME AND ADDRESS AUTHORIZED REPRESENTATIVE /4-, ACORD 28 (2009/12) PAGE 1 OF 2 © 2003-2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD