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<br />S'A"'. .ARM <br /> <br />A <br /> <br />INSURANCfp <br /> <br />COV,MTG,RMKS <br /> <br />POLICY#: 23-GF-5661-6 F <br />DOLFAY, ROBERT & JULIE <br />1937 EAGLE TRL <br />CENTERVILLE,MN 55038-7001 <br /> <br />APRIL 17, 2006 <br />HO - HOMEOWNERS <br /> <br />AGENT COPY <br />AGENT: F725/3668 <br /> <br />PHONE#: (H) 651-762-4643 <br />Eff date: (04/17/06) Curr date: (04/17/06) Time: (02:29 PM) <br /> <br />================================================================================. <br /> <br />**DEDUCTIBLE AND COVERAGE AMOUNT CHANGES** <br />Coverages: <br />(L-PERS LIAB <br /> <br />lQOOOOO) <br /> <br />-------------------------------------------------------------------------------- <br />- -------------------------------------------------------------------------------- <br /> <br />*~ADDITIONAL INTEREST CHANGES** <br /> <br />Rnwl bill to: ( <br />End bill to: ( <br />Change: (add <br />Type: (add' I <br />Subset #: ( ) <br />Loan #: ( <br /> <br />) <br />) <br />) <br />insured <br /> <br />Add'l Interest Name & Address: <br />(N) (CITY OF CENTERVILLE <br />(A) (1880 MAIN STREET <br />) ( ) ( <br />( ) ( <br />) ( ) ( <br />City: (CENTERVILLE <br />amended dees to insured and <br /> <br />) <br />) <br />) <br />) <br />) <br />) St: (MN) ZIP: (55038 <br />other add'l interests. <br /> <br />Agt Iss Dee sent. Send <br /> <br />-------------------------------------------------------------------------------- <br />-------------------------------------------------------------------------------- <br /> <br />RO REMARKS: (BILL GAFFNER HAS COPIES OF LETTER ETC SENT OVER EMAIL 4-17 ) <br />( ) <br /> <br />REMARKS APPLY TO: Fire <br /> <br />KLAPPENBACH, WILLIAM J <br />651-429-0241 INITIALS(MC <br /> <br />67- <br />