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Franco W Grisafi

Basic Policy Information

Policy #: 7010654
Term: 06/27/2017 - 06/27/2018
Tran Date: 06/27/2017
Tran Type: Renew policy
Tran Description: DNLD/Renew policy
Policy Type: Homeowners
Business Unit: Division: Arbor Insurance Group
Department: Personal Lines
Primary Service Group: Account Executive: Justin A Beidleman, jbeidleman@ArborIG.com
Account Representative: Personal Lines Service Team, info@ArborIG.com
Parent Company: Lititz Mutual Insurance Co
Writing Company: Lititz Mutual Insurance Co
Bill Method/Pay Plan: Direct bill
Current Policy Premium: $718.00
Full Term Premium: $718.00

First Named Insured

Name:
Firm Name:
DBA:
Dec Name: FRANCO WILLIAM GRISAFI
Address: 908 GRAYSTONE CIRCLE
NORTHAMPTON PA 18067
Business:
Residence: (610)283-3542
Cell:
Fax:
Email:

Location Information
Loc #0001: 908 GRAYSTONE CIRCLE, NORTHAMPTON, PA, 18067

Additional Interests
Name Type Address Phone Fax Email Interest In Payor Loan/Ref # Description Rank
WELLS FARGO MortgageePO BOX 100515, Loc #0001 X 0539695833 01
BANK NA #936 FLORENCE, SC,
ISAOA 29502515

Remarks
HO 00 03, 05/01, - HOMEOWNERS 3-SPECIAL FORM; HO 04 27, 04/02, - LTD FUNGI, WET DRY, BACT COV;
LMMUTCOND, 02/09, - LITITZ MUTUAL POL COND; GLB401, 02/09, - PRIVACY POLICY NOTICE; HO 01 37, 06/07, -
SPECIAL PROVISIONS - PA; L37, 03/14, - PENNSYLVANIA IMPORTANT NOTICE; IL 09 10, 07/02, - PENNSYLVANIA
NOTICE; IL N 088, 09/03, - PENNSYLVANIA FRAUD STATEMENT; HO-L-100, 01/11, - CENTURY VIP ENDORSEMENT;
L0455, 03/03, - IDENTITY FRAUD EXPENSE COVERGE; HO L 23 81, 02/14, - WATER BACKUP/SUMP DISCHG/OVRFL; HO
04 99, 10/00, - SINKHOLE COLLAPSE; HO 04 96, 10/00, - NO SEC II-LIAB COV HME DAY CAR

Lines of Business
Homeowners, Primary Location
Loc #0001: 908 GRAYSTONE CIRCLE, NORTHAMPTON, PA, Location Premium: $718.00
18067
Basic Coverages Form Type: 3, Special Form
All Peril Wind/Hail Theft
Coverage Limit Type/Amt Type/Amt Type/Amt Premium
Dwelling 275,000 1000 $719.00
Loss of use 82,500
Medical payments 4,000 $9.00
Other structures 27,500
Personal liability 400,000 $24.00

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Dec Page View - Franco W Grisafi Page 2 of 3

Personal property 137,500

Endorsements
Coverage Limit 1 Limit 2 Ded Type/Amt Premium
Century VIP Preferred
55,000
Coverage Endorsement
Deductible adjustment -$68.00
Fraud Assessment 25,000 $25.00
New home discount -$191.00
Sinkhole collapse $99.00
VIP Increased Coverage E 100,000
VIP Increased Coverage F 1,000
Water backup of sewers &
5,000 $101.00
drains

Underwriting Information
Construction
Year Built: 2015 Frame Condition:
Type:
Protection Year
Structure: Townhouse 05
Class: Occupied:
Purchase Purchase
Usage:
Date: Price:
Date
Dwelling Loc: Market Value:
Inspected:
Replacement
Occupancy: Roof Material:
Cost:
Secondary
Primary Heat: Oil Storage:
Heat:
Foundation: Housekeeping: Wind Class:
Storm
Sprinkler:
Shutters:

Rating Information
Square Ground Floor Perimeter
Footage: Area: Linear Ft.:
# in
# of Stories: # Families: 1
Household:
# Weeks
# of Rooms: # of Apts:
Rented:
Territory
31 Pers Liab Terr: Tax Code:
Code:
# Units Fire
Fire District: District Code:
Div:
Miles Fire Feet to # Fire
2 1,001
Stat: Hydrant: Divisions:
Fire Prem EC Prem
Fire/EC Rate:
Group: Group:
Visible to
Building Code: 05 Place Code:
Neighbor:
Fire Swimming Occupied
Extinguisher: Pool: Daily:
Smoke State
Diving Board:
Detector: Requirements:
Improved Prot
Deadbolt:
Class:
Rate Method:

Renovation Updates Protection Device

Wiring: Burglar:
Plumbing: Smoke:
Heating: Fire:
Roofing: Temp:
Exterior Paint:

Remarks
Payor Code: Mortgagee

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