Scribd
Upload
213 views1 page

Building Exclusion Form

This insurance document amends the policyholder's home insurance to exclude coverage for certain structures on the property. It lists up to five structures by location, construction, and use that are no longer covered under the policy's protection for other structures. The endorsement takes effect at 12:01 a.m. or 12:00 noon on the effective date listed and is part of the policy numbered and issued to the named insured.

Uploaded by

loozrrtuba
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
213 views1 page

Building Exclusion Form

This insurance document amends the policyholder's home insurance to exclude coverage for certain structures on the property. It lists up to five structures by location, construction, and use that are no longer covered under the policy's protection for other structures. The endorsement takes effect at 12:01 a.m. or 12:00 noon on the effective date listed and is part of the policy numbered and issued to the named insured.

Uploaded by

loozrrtuba
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
You are on page 1/ 1

Allstate Vehicle and Property Insurance Company

This Endorsement Changes Your Policy- Keep It with Your Policy


Building Structure Exclusion
______________________________________________________________________
Coverage B Other Structures Protection is changed as follows:
It is agreed that the following building structure(s) at your residence premises is (are) not covered under
Section I of this policy:

Schedule Other Structures Description


Location of Building
1. _________________________________

Construction
_________________________

Building Use
_________________________

_________________________________________________________________________________________________
2. _________________________________

_________________________

_________________________

_________________________________________________________________________________________________
3. _________________________________

_________________________

_________________________

_________________________________________________________________________________________________
4. _________________________________

__________________________

_________________________

_________________________________________________________________________________________________
5. _________________________________

__________________________

_________________________

_________________________________________________________________________________________________
This endorsement is effective from _________________, 20____ at

12:01 a.m.

12:00 noon standard time,

and forms a part of policy number ___________________________ issued to ________________________________ .

Signed____________________________________
Insured

Signed_______________________________________
Insured

Date _____________________________________

Date ________________________________________

AVP180

You might also like

pFad - Phonifier reborn

Pfad - The Proxy pFad of © 2024 Garber Painting. All rights reserved.

Note: This service is not intended for secure transactions such as banking, social media, email, or purchasing. Use at your own risk. We assume no liability whatsoever for broken pages.


Alternative Proxies:

Alternative Proxy

pFad Proxy

pFad v3 Proxy

pFad v4 Proxy