MS-PAF-0093127-10
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400 Quarry Row
Providence, RI 02903
Marrowstone Specialty Insurance (844) 555-0154
marrowstone.example
Scheduled Personal Articles - Schedule of Insured Items
Policy number: MS-PAF-0093127-10
Policy period: December 8, 2025 to December 8, 2026
Named insured: Margaret A. Ostrander and Raymond C. Ostrander, 1846 Hawkstone Drive,
Madison, WI 53711
Agent: Capitol Prairie Insurance Agency, Linda Schroedl
No. Class Description Amount of
insurance
1 Jewelry Lady's diamond solitaire ring, 0.72 ct round brilliant, 14k $4,900.00
yellow gold
2 Jewelry Lady's diamond solitaire ring, 0.58 ct old European cut, 14k $3,750.00
white gold filigree
3 Jewelry Lady's sapphire and diamond ring, 2.10 ct oval sapphire, 18k $4,600.00
white gold
4 Jewelry Cultured pearl strand, 18 in., 7 mm Akoya, 14k clasp $1,900.00
5 Jewelry Norwegian silver brooch (sølje), about 1920 $1,150.00
6 Jewelry Gent's Omega Seamaster wristwatch, 1968, stainless steel $4,150.00
7 Jewelry Diamond stud earrings, 0.50 ct total, 14k white gold $1,850.00
8 Jewelry Diamond tennis bracelet, 2.00 ct total, 14k white gold $4,300.00
9 Jewelry Diamond solitaire pendant, 0.40 ct, 14k white gold $1,450.00
10 Fine art H. Lindgaard, "Lake Mendota, November", oil on canvas $6,500.00
11 Fine art M. Kessel Dahl, "Three Pears", oil on panel $3,200.00
12 Fine art W. Kivisto, "Skein Lake, Ice-Out", oil on canvas (kept at 8815 $2,800.00
Skein Lake Road, Minocqua)
13 Fine art H. Lindgaard, "Untitled (Birches)", ink on paper $1,800.00
14 Fine art R. Østby, "Lofoten Harbor", acrylic on canvas $1,600.00
Amount
Jewelry, items 1 to 9 $28,050.00
Fine art, items 10 to 14 $15,900.00
Total amount of insurance $43,950.00
How the amounts were set
Items 1, 2 and 4 to 9 are scheduled at the values in the appraisal by Solheim Gem Appraisal
dated September 17, 2024. Item 3 is scheduled at the value declared when it was added to
the policy on August 21, 2017. Items 10 to 14 are scheduled at the values in the appraisal by
Prairie Line Fine Art Appraisals dated October 19, 2021.
Terms
Deductible: none.
Jewelry is covered for loss, theft, damage and unexplained disappearance, anywhere in
the world. A loss is settled at the cost to replace with like kind and quality, up to the
amount of insurance for the item.
Fine art is covered at agreed value.
A newly acquired article of a class already scheduled is covered for 30 days, up to 25% of
the total for that class, and must be reported within those 30 days.
Premium
Item Amount
Jewelry $490.88
Fine art $193.12
Annual premium $684.00
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| Value | Now |
|---|---|
| valuables-policy-2026.policy_number | MS-PAF-0093127-10 |
| valuables-policy-2026.expiration | 2026-12-08 |
| valuables-policy-2026.insured_value | 43950 |
| valuables-policy-2026.annual_premium | 684 |
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