EFTA01124121.pdf

WELLS SCHEDULE OF INSURANCE FARGO INSURANCE Wells Fargo Insurance Services USA Inc. Prepared for: Leon and Debra Black 330 Madison Avenue, 7th Floor 7 As of: July 16. 2013 COMPANY POLICY NO. TERM EXP. AMOUNT &/OR COVERAGE/REMARKS DATE LIMITS American I Year 09 26/13 I'ACKAC' am 11W Automobile Location: Insurance Company $7,048,000 Additions & Alterations / Personal Property $1,000 Deductible (waived for losses over $50,000) $500,000 Personal Liability $50,000,000 Excess Liability Personal /Excess Liability Coverage extended to cover: I) 2) 3) 4) 5) 6) 7) 8) 9) 10) $5,000,000 Excess Uninsured/Underinsured Liability extended to cover 12 automobiles and 16 operators. All Risk Coverage provided (subject to policy terms, conditions, & exclusions) and Extended Replacement Cost Coverage on the Additions & Alterations. Replacement Cost Coverage applies to Personal Property. This schedule is a brief summary of the policies on our records and is not intended to provide details which are fully described in the actual policies. Page I EFTA01124121  WELLS ti RGO INSURANCE SCHEDULE OF INSURANCE Wells Fargo Insurance Services USA Inc. Prepared for: 330 Madison Avenue, 7111Floor Now vort, NY 101017 As of: July 16, 2013 COMPANY POLICY NO. TERM EXP. AMOUNT &/OR COVERAGE/REMARKS DATE LIMITS The American I Year 09/01/14 C OPE 3 ' Insurance Company Location $242,000 Additions & Alterations / Personal Property S1,000 Deductible (waived for losses over $50,000 $500,000 Personal liability (extended from policy # All Risk Coverage provided (subject to policy terms, conditions, & exclusions) and Extended Replacement Cost Coverage on the Additions & Alterations. Replacement Cost Coverage applies to Personal Property. Pacific Indemnity I Year 03/01/14 HOMEOWNERS POLICY Company/Chubb Location $14,616,000 Dwelling $9,122,200 Other Structures $7,308,000 Personal Property $10,000 Deductible (waived for losses over S50,000) $1,000,000 Personal Liability All Risk Coverage provided (subject to terms, conditions, & exclusions) and Extended Replacement Cost Coverage on Dwelling. Replacement Cost Coverage applies to Personal Property. This schedule is a brief summary of he policies on our records and is not intended to provide details which are fully described in the actual policies. Page 2 EFTA01124122  WE it ,S INSURANCE SCHEDULE OF INSURANCE 0 Wells Fargo Insurance Services USA Inc. Prepared for: 330 Madison Avenue, 711 Floor 17 As of: July 16, 2013 COMPANY POLICY NO. TERM EXP. AMOUNT &/OR COVERAGE/REMARKS DATE LIMITS Fireman's Fund I Year 09 30/13 HOMEOWNERS POLICY Insurance Company Location: $4,941,000 Dwelling $2,409,064 Other Structures $1,560,700 Personal Property $5,000 Deductible (waived for losses over $50k) $500,000 Personal Liability (extended from policy I/ IIIIIIIIIIIIIII All Risk Coverage provided (subject to terms, conditions, & exclusions) and Extended Replacement Cost Coverage on Dwelling. Replacement Cost Coverage applies to Personal Property. American Auto I Year 12 29 13 HOMEOWNERS POLICY Insurance Company Location: $10,988,000 Dwellin $2,197,600 Other StructuresIflISSPO wwlr $7,691,600 Personal Property SI0,000 Non-Wind Deductible (waived for losses over $50,000) $50,000 Hurricane Deductible $500,000 Personal Liability (extended from policy 11 All Risk Coverage (subject to terms, conditions, & exclusions) & Extended Replacement Cost Coverage on Dwelling. Replacement Cost Coverage applies to Personal Property. This schedule is a brief summary of he policies on our records and is not intended to provide details which are fully described in the actual policies. Page 3 EFTA01124123  WELLS SCHEDULE OF INSURANCE ARUO INSURANCE Wells Fargo Insurance Services USA Inc. Prepared for: ) -) ) 330 Madison Avenue, 7th Floor IMO 10017 As of: July 16, 2013 COMPANY POLICY NO. TERM EXP. AMOUNT &/OR COVERAGE/REMARKS DATE LIMITS Fireman's Fund I Year 07 18/1-1 H MEOWNER: INS MAN _F. Insunnwe Company Location $5,478,000 Dwelling S1,095,600 Other Structures $1,369,600 Personal Property $25,000 Non-Wind Deductible (waived for losses over $50,000) $50,000 Hurricane Deductible $500,000 Personal Liability (extended from policy # NAX03221429) All Risk Coverage provided (subject to terms, conditions, & exclusions) & Extended Replacement Cost Coverage on Dwelling. Replacement Cost Coverage applies to Personal Property. Fireman's Fund I vein 0625 1.1 HOMEOWNERS POLICY Insurance Company Location: Named Insured $2,500,000 Dwelling $500,000 Other Structures $625,000 Personal Property $10,000 Non-Wind Deductible (waived for losses over $50,000) $50,000 Hurricane Deductible $500,000 Personal Liability (extended from policy It NAX03221429) All Risk Coverage provided (subject to terms, conditions, & exclusions) & Extended Replacement Cost Coverage on Dwelling. Replacement Cost Coverage applies to Personal Properly. This schedule is i brief summary of the policies on our records and is not intended to provide details which are fully described in the actual policies. Page 4 EFTA01124124  WELLS FARGO ENDURANCE SCHEDULE OF INSURANCE Wells Fargo Insurance Services USA Inc. Prepared for: 330 Madison Avenue, 7th Floor Now V Ark NV tow 7 As of: July 10. 2U I .i COMPANY POLICY NO. TERM EXP. AMOUNT 8r/OR I COVERAGE/REMARKS DATE LIMITS Fireman's Fund I Year 0625/14 FLOOD INSURANCE Insurance Company, of Ohio Locations: I. 3. $15,000,000 Dwelling/Personal Properly Blanket Limit(all locations) $100,000 Deductible The American I Year 1228/13 IIOMEOWNEFtS POLICY Insurance Company Location: Additional Insureds S3,089,000 Dwelling $617,800 Other Structures $2,162,300 Personal Property $5,000 Deductible $500,000 Personal Liability (extended from policy All Risk Coverage provided (subject to terms, conditions, & exclusions) & Extended Replacement Cost Coverage on Dwelling. Replacement Cost Coverage applies to Personal Property. This schedule is a brief summary of he policies on our records and is not intended to provide details which are fully described in the actual policies. Page 5 EFTA01124125  WELLS INSURANCE SCHEDULE OF INSURANCE EARGo Wells Fargo Insurance Services USA Inc. Prepared for: 330 Madison Avenue, t h Floor New York, NY 10017 As of: July 16, 2013 COMPANY POLICY NO. TERM EXP. AMOUNT &/OR COVERAGE/REMARKS DATE LIMITS Associated Indemnity I Year 07/26/13 AUTOMOBILE: Corporation I) 2) 3) 4) 5) 6) 7) 8) 9) 10) I I) 12) $500,000 Liability $500,000 Uninsured/Underinsured Motorists $100,000 Medical Payments S175,000 Personal Injury Protection $1,000 Other Than Collision Deductible $1,000 Collision Deductible Included Rental Reimbursement Included Towing & Labor Costs *AV=Agreed Value This schedule is a brief summary of the policies on our records and is not intended to provide details which are fully described in the actual policies. Page 6 EFTA01124126  WELLS SCHEDULE OF INSURANCE FARGO INSURANCE Wells Fargo Insurance Services USA Inc. Prepared for: Leon and Debra Black 330 Madison Avenue, 7th Floor New York, NY 10017 As of: July 16, 2013 COMPANY POLICY NO. TERM EXP. AMOUNT &/OR COVERAGE/REMARKS DATE LIMITS The State Insurance I Year 09/28/13 WORKERS COMPENSATION POLICY (NYI Fund 9 Full-Time In-servants 8 Full-Time Out-servants Clerical Office Employees Fireman's Fund I Year 04 20/14 JEWELRY Insurance Company $12,264,371 Scheduled Jewelry Coverage $500,000 Blanket Jewelry Coverage ($50,000 limit per item) Primary and Excess Fine Arts Insurance Program summarized under separate schedule. This schedule is a brief summary of the policies on our records and is not intended to provide details which are fully described in the actual policies. Page 7 EFTA01124127 WELLS INSURANCE SCHEDULE OF INSURANCE FARGO Wells Fargo Insurance Services USA Inc. Prepared for: Benjamin Black 330 Madison Avenue, 7th Floor Joshua Black New York. NY 10017 Aso[ July 16, 2013 COMPANY POLICY NO. EXP. AMOUNT &/OR COVERAGE/REMARKS DATE LIMITS American I Year 12/14/13 PACK A 'EPOLICY Automobile Location Insurance Company $581,000 Additions & Alterations / Personal Property SI,000 Deductible (waived for losses over S50k) S1,000,000 Personal Liability S3,000,000 Excess Liability Excess Liability Coverage extended to cover: I oratIn • I) 2) SI,000,000 Excess Uninsured/Underinsured Liability extended to cover a 2009 Audi A4. All Risk Coverage provided (subject to policy terms, conditions, & exclusions) and Extended Replacement Cost Coverage on the Additions & Alterations. Replacement Cost Coverage applies to Personal Property. This schedule is a brief summary of the policies on our records and is not intended to provide details which are fully described in the actual policies. Page EFTA01124128