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W, <br />AAA Insurance <br />underwritten by CSAA Insurance Exchange <br />insurance PO Box 22221 Oakland, CA 94623-2221 800.922.8228 <br />Named Insured and Mailing Address <br />ADELINA MORENO <br />MARTHA MORENO <br />142 CENTER ST <br />REDWOOD CITY, CA 94061-3807 <br />Agency Information <br />EVELYN KING <br />510 VETERANS BLVD <br />STE A <br />REDWOOD CITY, CA 94063 <br />(650)216-3169 <br />Insured Location <br />142 CENTER ST <br />REDWOOD CITY, CA 94061 <br />Description of Property <br />Homeowners Policy Declarations <br />Renewal <br />For questions or changes call: 800.922.8228 <br />Policy Number: CAH3105081304 <br />Membership Number: 4290050493219519 <br />Notice Date: 11/15/2024 <br />Home Phone #: (650) 369-7943 <br />Business Phone #: <br />Named Insured(s) <br />ADELINA MORENO <br />MARTHA MORENO <br />Premium to be paid by: JPMORGAN CHASE BANK, N.A. <br />YR Built <br />Construction Type <br />12:01 A.M. Standard Time, but not <br /># of Family Units <br />1943 <br />prior to the time applied for or, if <br />Owner Occupied <br />From: <br />this is a replacement Declarations, <br />Your <br />01/14/2025 <br />not prior to the time coverage <br />Policy <br />$796,300 <br />change was requested. <br />Period <br />$500,000 <br />$1,000 $25,000 <br />Workers' Compensation and Employers' Liability Insurance <br />To: <br />12:01 A.M. Standard Time. <br />01/14/2026 <br />Notice Date: 11/15/2024 <br />Home Phone #: (650) 369-7943 <br />Business Phone #: <br />Named Insured(s) <br />ADELINA MORENO <br />MARTHA MORENO <br />Premium to be paid by: JPMORGAN CHASE BANK, N.A. <br />YR Built <br />Construction Type <br />Occupancy <br /># of Family Units <br />1943 <br />Frame <br />Owner Occupied <br />1 -Single Family <br />Coverages and Limits of Insurance: Insurance is provided for the following coverages only when a limit is shown. The limit of liability <br />for this structure (Coverage A — Dwelling) is based on an estimate of the cost to rebuild your home, including an approximate cost for <br />labor and materials in your area, and specific Information that you have provided about your home. <br />Section I <br />Section II <br />A <br />B <br />C D <br />E <br />F <br />Dwelling <br />Other <br />Structures <br />Personal Loss of Use <br />Property <br />Personal Liability <br />Each Occurrence <br />Medical Payments to Others <br />Each Person Each Accident <br />$796,300 <br />$79,700 <br />$597,200 $350,800 <br />$500,000 <br />$1,000 $25,000 <br />Building Code Upgrade Coverage - 25% of the Coverage A Limit shown above may be used for increased costs <br />due to enforcement of ordinance or law. Terms, conditions, and restrictions are outlined in the California Building <br />Code Upgrade Coverage Disclosure. <br />Section I Only:Your Section I Coverage Limits have been changed to reflect changes in Construction costs and other matters <br />affecting replacement costs <br />Deductible- Section 1 <br />$500 (In case of loss under Section I, we cover only that part of the loss over the deductible) <br />This policy does not provide Earthquake Insurance. <br />This policy does not provide Flood Insurance. <br />Forms and Endorsements <br />Form Number <br />Forms and Endorsements Made Part of this Policy <br />Premium <br />61 2000 CA 10012010 (CA 7/2015) Homeowners Policy Special Form <br />Included <br />HS AE3 CA 10 21 <br />Amendatory Endorsement - California <br />Included <br />HS WRS CA 11 21 <br />Wildfire Response Services <br />Included <br />438BFUNS CA <br />Lenders Loss Payable <br />Included <br />HO -125 01 21 <br />125% Extended Replacement Cost Coverage <br />Included <br />HO -90 10 86 <br />Workers' Compensation and Employers' Liability Insurance <br />$4.00 <br />1075 05012018 Page 1 of 2 <br />