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EFTA01124121

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Wells Fargo Insurance Services USA Inc. 330 Madison Avenue, 7th Floor 7 WELLS FARGO INSURANCE SCHEDULE OF INSURANCE COMPANY American Automobile Insurance Company POLICY NO. TERM I Year EXP. DATE 09 26/13 AMOUNT &/OR LIMITS $7,048,000 $1,000 $500,000 $50,000,000 $5,000,000 Prepared for: Leon and Debra Black As of: July 16. 2013 COVERAGE/REMARKS I'ACKAC' am 11W Location: Additions & Alterations / Personal Property Deductible (waived for losses over $50,000) Personal Liability Excess Liability Personal /Excess Liability Coverage extended to cover: I) 2) 3) 4) 5) 6) 7) 8) 9) 10) 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. 330 Madison Avenue, 7111Floor Now vort, NY 101017 Prepared for: As of: July 16, 2013 COMPANY The American Insurance Company POLICY NO. TERM EXP. DATE AMOUNT &/OR LIMITS COVERAGE/REMARKS I Year 09/01/14 $242,000 S1,000 $500,000 C OPE 3 ' Location Additions & Alterations / Personal Property Deductible (waived for losses over $50,000 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 Company/Chubb I Year 03/01/14 $14,616,000 $9,122,200 $7,308,000 $10,000 $1,000,000 HOMEOWNERS POLICY Location Dwelling Other Structures Personal Property Deductible (waived for losses over S50,000) 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 0 INSURANCE SCHEDULE OF INSURANCE Wells Fargo Insurance 330 Madison Avenue, Services USA Inc. 711Floor Prepared for: 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 Structures IflISSPO wwlr $7,691,600 Personal Property SI 0,000 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 ARUO INSURANCE SCHEDULE OF INSURANCE Wells Fargo Insurance Services 330 Madison Avenue, 7th Floor USA Inc. Prepared for: ) -) ) IMO 10017 As of: July 16, 2013 COMPANY POLICY NO. TERM EXP. AMOUNT &/OR COVERAGE/REMARKS DATE LIMITS Fireman's Fund Insunnwe Company I Year 07 18/1-1 H MEOWNER: Location INS MAN _F. $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. 330 Madison Avenue, 7th Floor Now V Ark NV tow 7 Prepared for: As of: July 10. 2U I .i COMPANY POLICY NO. TERM EXP. DATE AMOUNT 8r/OR LIMITS Fireman's Fund Insurance Company, of Ohio I Year 0625/14 $15,000,000 $100,000 The American I Year 1228/13 Insurance Company S3,089,000 $617,800 $2,162,300 $5,000 $500,000 I COVERAGE/REMARKS FLOOD INSURANCE Locations: I. 3. Dwelling/Personal Properly Blanket Limit(all locations) Deductible IIOMEOWNEFtS POLICY Location: Additional Insureds Dwelling Other Structures Personal Property Deductible 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 EARGo INSURANCE SCHEDULE OF INSURANCE Wells Fargo Insurance Services USA Inc. 330 Madison Avenue, t h Floor New York, NY 10017 Prepared for: As of: July 16, 2013 COMPANY Associated Indemnity Corporation POLICY NO. TERM EXP. DATE AMOUNT &/OR LIMITS COVERAGE/REMARKS I Year 07/26/13 $500,000 $500,000 $100,000 S175,000 $1,000 $1,000 Included Included AUTOMOBILE: I) 2) 3) 4) 5) 6) 7) 8) 9) 10) I I) 12) Liability Uninsured/Underinsured Motorists Medical Payments Personal Injury Protection Other Than Collision Deductible Collision Deductible Rental Reimbursement 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 FARGO INSURANCE SCHEDULE OF INSURANCE Wells Fargo Insurance 330 Madison Avenue, 7th New York, NY 10017 Services USA Inc. Prepared for: Leon and Debra Black Floor As of: July 16, 2013 COMPANY POLICY NO. TERM EXP. DATE AMOUNT &/OR LIMITS COVERAGE/REMARKS The State Insurance Fund I Year 09/28/13 WORKERS COMPENSATION POLICY (NYI 9 Full-Time In-servants 8 Full-Time Out-servants Clerical Office Employees Fireman's Fund Insurance Company I Year 04 20/14 $12,264,371 $500,000 JEWELRY Scheduled Jewelry Coverage 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 FARGO INSURANCE SCHEDULE OF INSURANCE Wells Fargo Insurance Services USA Inc. 330 Madison Avenue, 7th Floor New York. NY 10017 COMPANY American Automobile Insurance Company POLICY NO. I Year EXP. DATE 12/14/13 AMOUNT &/OR LIMITS $581,000 SI,000 S1,000,000 S3,000,000 Prepared for: Benjamin Black Joshua Black Aso[ July 16, 2013 COVERAGE/REMARKS PACK A 'EPOLICY Location Additions & Alterations / Personal Property Deductible (waived for losses over S50k) Personal Liability 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