DM-UM-3310772-07
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PO Box 2210
Viroqua, WI 54665
Driftless Mutual Insurance Company (855) 555-0112
driftlessmutual.example
Personal Umbrella Liability Policy Declarations
Policy number: DM-UM-3310772-07
Policy period: March 1, 2026 to March 1, 2027
Named insured: Raymond C. Ostrander and Margaret A. Ostrander
Limit of liability: $2,000,000.00 each occurrence
Retained limit: $250.00 for an occurrence that no underlying policy covers
What this policy sits over
Underlying policy Required liability limit
Homeowners, 1846 Hawkstone Drive, Madison (DM-HO-2087341-07) $500,000.00
Seasonal dwelling, 8815 Skein Lake Road, Minocqua (Pinery Town $300,000.00
Mutual PTM-SD-551208-22)
Automobile, 2022 Toyota RAV4 (DM-PA-6642190-15) $250,000 / $500,000 /
$100,000
Automobile, 2017 Ford F-150 (DM-PA-7718305-09) $250,000 / $500,000 /
$100,000
Watercraft, two boats under 26 feet (DM-WC-5120884-12) $300,000.00
If an underlying policy is cancelled or its limit is reduced, this policy pays only as though the
required limit were still in force. Tell your agent within 30 days of buying or selling a car, a boat
or a property.
Premium
Item Amount
Annual premium $412.00
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| Value | Now |
|---|---|
| umbrella-policy.policy_number | DM-UM-3310772-07 |
| umbrella-policy.expiration | 2027-03-01 |
| umbrella-policy.insured_value | 2000000 |
| home-policy-2026.policy_number | DM-HO-2087341-07 |
| cabin-policy-2026.policy_number | PTM-SD-551208-22 |
| auto-policy-rav4.policy_number | DM-PA-6642190-15 |
| auto-policy-f150.policy_number | DM-PA-7718305-09 |
| boat-policy.policy_number | DM-WC-5120884-12 |
| umbrella-policy.annual_premium | 412 |
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