
| Dwelling Coverage | $208,000.00 |
| Other Structures | $20,800.00 |
| Personal Property | $104,000.00 |
| Additional Living Expenses | $62,400.00 |
| Personal Liability | $300,000.00 |
| Medical Payment | $5,000.00 |
| Deductible: Policy | $1,000.00 |
| Annual Premium | $317.00 |
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