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DECLARATIONS Coverage afforded by this policy is We will provide the provided by: insurance described in this policy in return for the premium STATE FARM FIRE AND CASUALTY COMPANY and compliance with all applicable 222 SOUTH 84TH STREET provisions of this policy. LINCOLN NE 68510 34- BR- 5615 -1 Policy Number A Stock Company with Home Offices in Bloomington, Illinois. Named Insured and Mailing Address VOLK, CALVIN STEPHANIE 458 N SEDONA DR WEST FARGO, ND 58078 -8104 The Policy Period begins and ends at Automatic Renewal If the Policy 12:01 a.m. Standard Time at the residence Period is shown as 12 months, this premises. policy will be renewed auto- matically subject to the premiums, 12/20/2013 Effective Date rules and forms in effect each 12months- Policy Period succeeding policy period. If this 12/20/2014 Expiration of Policy Period policy is terminated, we will give you and the Mortgagee /Lienholder Limit of Liability Section 1 written notice in compliance with 276,000 Dwelling (Coverage A) the policy provisions or as required by law. Deductibles Section 1 0.5%/$1380 Policy Type ALL LOSSES In case of loss under Homeowners Policy this policy, the deductible will be Dwell Repl Cost Similar Construction applied per occurrence and will be Increase Dwlg Up to $55,200 Option ID deducted from the amount of the loss. Other deductibles may apply Location of Premises refer to your policy. 458 N SEDONA DR WEST FARGO, ND 58078 -8104 Policy Premium $2,070.00 Forms, Options, Endorsements FP -7955 HOMEOWNERS POL OPT JF J &F 2500/5000 LSP Al SMLR CONST -A LSP B1 LMT RPLC COST -B OPT ID COV A -INCR DWLG OPT OL BLD ORD /LAW -10% FE- 5326.2 SEWER BACK -UP FE- 3500.1 HO -W POL END FE -2340 AMENDATORY END Additional Insured Agent Name Address CASS COUNTY GOVERNMENT JEFFERSON, THOMAS E PO BOX 2806 3330 FIECHTNER DRIVE SW FARGO, ND 58108 -2806 FARGO, ND 58103 -2321 (701)234 -0507 Loan Number: Prepared: November 12, 2013 968A Agent's Code 559 -916.5 MORTGAGEE COPY