FICTITIOUS DOCUMENT
— FORGE DEMO ONLY —
Granite Peak MutualPersonal Lines · Estate & High-Value Homeowners
Homeowners Declarations
Renewal Declarations — Page 1 of 1

Policy Identification

Policy NumberGPM-HO-••••7731
Policy TypeHomeowners — Estate Form
Policy Period From2025-09-01
Policy Period To2026-09-01
Renewal Date2026-09-01
Underwriting OfficeHartford Estate Unit

Named Insured & Risk Location

Named InsuredKestrel Lane LLC
Tax ID (EIN)88-04•••••
Mailing AddressKettle Hollow, CT
Risk / Insured LocationKettle Hollow, CT compound

Coverage Limits

CoverageDescriptionLimit
A — DwellingMain residence$22,000,000
B — Other StructuresGuest house, boathouse, garages$6,500,000
C — Contents / Personal PropertyExcludes scheduled fine art (covered separately)$8,000,000
D — Loss of UseAdditional living expense$4,400,000
E — Personal LiabilityEach occurrence$2,000,000
F — Medical PaymentsEach person$25,000

Coverage C expressly excludes scheduled fine art and collections, which are insured under a separate Fine Art & Collections Floater (Ardent Specialty, policy ASF-FA-••••9902).

Deductibles & Premium

All-Perils Deductible$100,000
Wind / Hail Deductible2% of Coverage A
Annual Premium$186,400
Billing MethodAnnual auto-draft

Premium Billing

Draft AccountTri-Valley Community Bank ••••2258
Account NameProperty Operating
Wire / EFT Coordinates[REDACTED — SPECIMEN]
Routing Number[REDACTED — SPECIMEN]
Granite Peak Mutual · Homeowners Declarations · GPM-HO-••••7731 Fictitious Document — Forge Demo Only