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1 yjtdwestl Viutua <br />Insuring Midwest Values <br />Since 1891 <br />Renewal Coverage Summary <br />DB <br />............................................................ <br />GRMN0560025417 <br />FItOM 1..ICY PER.QD.... <br />08/17/10 <br />08/17/11 <br />12.01 AM STANDARD TIME <br />00250 <br />IAME ..INSURER_AN..D ADDRESS. <br />LAWRENCE JOSEPH FERBER <br />DBA: LARRY'S AUTO BODY <br />17441 BAUGH ST <br />RAMSEY, MN 55303 <br />ASPEN AGENCY LLC <br />2669 COON RAPIDS BLVD NW <br />COON RAPIDS, MN 55433 <br />Phone: (763) 755-7000 <br />19 <br />BUSINESSOWNERS SUPPLEMENTAL DECLARATIONS <br />LOCATION ADDRESS(ES) <br />Prems. Bldg. <br />No. No. Address <br />1 1 17441 BAUGH ST, RAMSEY MN 55303 <br />DESCRIPTION OF PREMISES <br />Prems. Bldg. <br />No. No. Occupancy Construction <br />1 1 Auto Body or Paint Shops Frame <br />COVERAGES PROVIDED <br />COVERAGES <br />Prems. Bldg. Limit of <br />No. No. Coverages Insurance <br />1 1 Building - RC $94,800 <br />1 1 Personal Property/Contents - RC $19,000 <br />Automatic Increase <br />in Insuranc <br />6% <br />6% <br />Ded <br />$1,000 <br />$1,000 <br />OPTIONAL COVERAGES <br />Prems. Bldg. <br />No. No. Coverages Limit Ded <br />1 1 Uninsured Motorist $500,000 <br />1 1 Underinsured Motorist $500,000 <br />1 1 Personal Injury Protection $0 <br />1 1 Non -Owned Auto Liability $1,000,000 <br />1 1 Loss of Income/Extra Expense ACTUAL LOSS SUSTAINED <br />1 1 Garagekeepers- Collision - Primary $60,000 $1,000 <br />1 1 Garagekeepers- Comprehensive - Primary $60,000 $1,000 <br />DATE 07/20/2010 <br />PAGE 2 <br />