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APN# 138-28-112-039; Assets, Proceeds, Fixtures, Contracts, Deeds of Trust, Security Deeds, Bonds,
Mortgages, Chattel Papers, Title, Financial Notes, Financial Instruments, (and/or Ownership or Possession
of such Documents and Records: Promissory Notes and/or Electronic Notes. Lot (178) in Book Six (6) OF
Cimarron Ridge Unit 4, as Shown By Map Thereof on file in book 51 of plats, Page 75, County of Clark,
State of Nevada. also known by street and number as 8221 Hydra Lane, Las Vegas, Nevada 89128.
 DECLARATIONS Coverage afforded by this policy is provided by:
State Farm Fire and Casualty Company
2700 South Sunland Drive
We will provide the insurance described in this policy Tempe, AZ 85282-3387
in return for the premium and compliance with all
applicable provisions of this policy. A Stock Company with Home Offices in Bloomington,
Illinois.
28-B7-G453-3 Policy Number
Named Insured and Mailing Address
Selassie, Frasberg
8221 Hydra Ln
Las Vegas, NV 89128-1633
The Policy Period begins and ends at 12:01 a.m. Automatic Renewal - If the Policy Period is shown as
Standard Time at the residence premises. 12 months, this policy will be renewed automatically
12/12/2018 Effective Date subject to the premiums, rules and forms in effect each
12 months - Policy Period succeeding policy period. If this policy is terminated, we
12/12/2019 Expiration of Policy Period will give you and the Mortgagee/Lienholder written
notice in compliance with the policy provisions or as
Limit of Liability - Section 1 required by law.
$199,000 Dwelling
$149,250 Personal Property (Minimum 75% of Deductibles - Section 1 1% $1,990
Dwelling) ALL LOSSES In case of loss under this policy, the
Limit of Liability - Section 2 deductible will be applied per occurrence and will be
$300,000 Personal Liability deducted from the amount of the loss.
$1,000 Medical Payments to Others
Earthquake:
Policy Type Homeowners
A1 - Replacement Cost - Similar Construction Policy Premium $ 961
Increased Dwelling Up to $39,800 - Option ID
Location of Premises
8221 Hydra Ln
Las Vegas, NV 89128-1633

Forms, Options, & Endorsements

FP-7955 Homeowners Policy Ordinance/Law 10% $19,900
Homeowners Policy Endorsement Amendatory Endorsement
Actual Cash Value Endorsement Back-Up Dwell/Listed Property
Mortgagee & Addl. Interests Agent Name & Address
Lienholder Tami Zornek
NRMG NEVADA PARTNERS, LLC Zornek Insurance Agency Inc
8221 Hydra Ln 7450 W Lake Mead Blvd Ste 3
Las Vegas, NV 89128-1633 Las Vegas, NV 89128-0295
Loan Number: N/A (702) 545-0000

Prepared: 04-05-2019 Agent's Code:2397

559-916.4 APPLICANT COPY

     AMENDMENT
 

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