HOMEOWNER POLICY
DECLARATIONS
Non-Assessable
Page 1 of 3
These Declarations are a part of the policy named above and identified by policy number below. They
supersede any Declarations issued earlier. Your Homeowner Policy will provide the insurance described in
this policy in return for the premium and compliance with all applicable policy provisions. See policy for
details regarding the other coverages and additional coverage options.
Policy Number: Policyholder:
9234HR155032 (Named Insured)
MOHI UDDIN &
MUNNI H AKTER
Issued: 8943 GUILDER ST
MAY 13, 2025 POWELL, OH 43065-9037
Policy Period From:
JUN 16, 2025 to JUN 16, 2026 but only if the required premium for this period has been paid, and only for
annual renewal periods if premiums are paid as required. Each period begins and ends at 12:01 A.M. standard
time at the Residence Premises.
Where to access your policy documents
In order to view, print, or save your policy documents that do not contain personally identifiable information,
go to [Link]/insurancecontracts on your Internet browser and enter your policy number.
You can get hard copies of your documents mailed or emailed to you free of charge by calling the customer
service number on the bottom of this document. Please note that any policy documents containing
personally identifiable information are not available for online viewing, unless you have registered for online
account access. Go to [Link]/signup to create an account.
Attention
Your policy includes the Limited Roof Surfaces Settlement Windstorm or Hail Losses
endorsement. This endorsement provides protection for your roof surfaces from loss caused
by windstorm or hail based on a pre-determined schedule using roof type and roof age. You
may be receiving a reduced premium with this endorsement on your policy. It is
important that you inform your agent promptly of any “roof surface” updates made to your
roof (replacement) as the roof type and roof renovated year displayed on your Declarations
Page will be used to settle covered losses payable under this endorsement at time of loss and
factor into your premium amount.
Residence Premises Information:
8943 GUILDER ST PURCHASED: 06/2016 ROOF YEAR: 2024
POWELL 008 OCCUPANTS IN DWELLING ROOF: COMPOSITION SHINGLE
OH 43065-9037 ONE FAMILY SUPPLEMENTAL HEATING? Y
BUILT: 1991 PROTECTION CLASS 1
CONSTRUCTION: FRAME FD COLUMBUS
RATED BATHROOMS: 2.5 COLUMBUS FS 27
MILES FROM FIRE DEPT: 003
Additional Rating Information: The following is used when determining your policy’s premium. Please
advise immediately if this information is incorrect.
RATING AGE OF INSURED: 29
H 07 00 07 16
HOMEOWNER POLICY DECLARATIONS
Page 2 of 3
SECTION I
Property Coverages Limits of Liability Deductible: $1,000 ALL PERILS
COVERAGE-A-DWELLING $316,700 In case of a loss under Section I, we cover
COVERAGE-B-OTHER STRUCTURES $31,670 only that part of each loss over the
deductible stated.
COVERAGE-C-PERSONAL PROPERTY $237,525
EXCEPTIONS
COVERAGE-D-LOSS OF USE ALS*
1% OF COVERAGE A - DWELLING LIMIT
*ACTUAL LOSS SUSTAINED =$3,[Link] DEDUCTIBLE APPLIES TO
WINDSTORM OR HAIL LOSSES.
PAYMENT NOT TO EXCEED 24
MONTHS
SECTION II
Liability Coverages Limits of Liability
COVERAGE-E-PERSONAL LIABILITY $300,000
FOR EACH OCCURRENCE:PROPERTY
DAMAGE AND BODILY INJURY
COVERAGE-F-MEDICAL PAYMENTS TO $1,000
OTHERS EACH PERSON
OTHER COVERAGES APPLICABLE
See Policy or Endorsements for details regarding the Other Coverages that apply to your policy.
Other Coverages Limits Of Liability
Limited Roof Surfaces Settlement Windstorm or Hail Losses APPLIES
Biological Deterioration or Damage $10,000
Brand New Belongings APPLIES
Building Ordinance or Law 10%
Dwelling Replacement Cost - 150% APPLIES
Inflation Protection APPLIES
Boeckh Index 1089.2
Landlord's Furnishings $2,500
Loss Assessment $1,000
Water Backup Limited $5,000
Water Backup Deductible $1,000
Tools $2,500
PREMIUM SUMMARY
Premium Based On Premium Amount
POLICY PREMIUM $1,391.92
WATER BACKUP $96.99
Annual Premium $1,488.91
HOMEOWNER POLICY
DECLARATIONS
Non-Assessable
Page 3 of 3
Policy Number: Policyholder:
9234HR155032 (Named Insured)
MOHI UDDIN
Issued: Policy Period From:
MAY 13, 2025 JUN 16, 2025 to JUN 16, 2026
Annual Premium Includes Discounts For:
HOME/CAR
HOME PROTECTIVE DEVICE
HOME RENOVATION
MULTI LINE
GOOD PAYER
FORMS and ENDORSEMENTS MADE PART OF POLICY
H 00 03 0716 Your Nationwide Homeowners Policy
H 02 07 0716 Brand New Belongings
H 03 06 0716 Dwelling Replacement Cost - 150%
H 02 03 0716 Limited Water Back-Up and Sump Discharge or Overflow Coverage
H 03 11 0716 Loyalty Rewards - Homeowner
H 01 00 OH 0716 Special Provisions - Ohio
H 03 64 0622 Limited Roof Surfaces Settlement Windstorm or Hail Losses
ADDITIONAL INTERESTS
FIRST MORTGAGEE
WELLS FARGO BANK NA 936
ISAOA
PO BOX 100515
FLORENCE, SC 29502-0515
LOAN #0541457917
Issued By: NATIONWIDE GENERAL INSURANCE COMPANY
Home Office Columbus, OH
Nationwide 24-Hour Claims Number : 1-800-421-3535
For Billing or Policy Questions : 1-614-876-1224
Your NATIONWIDE AGENT: STANLEY INSURANCE GROUP 1-614-876-1224