lanternhouse declarations
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PO Box 60914
Saint Paul, MN 55164
Lanternhouse Insurance (877) 555-0155
lanternhouse.example
Renters Policy Declarations (amended)
Policy number LH-R20-5590318
Policy period June 1, 2025 to June 1, 2026, 12:01 a.m. standard time
Declarations issued September 9, 2025, replacing the declarations of May 12, 2025
Named insured Theodore K. Nakagawa-Reed
Insured location 3318 Brackenmere Avenue S, Apt 3, Minneapolis, MN 55406
Additional interest (landlord) Fourgable Properties LLC, PO Box 18274, Minneapolis, MN 55418
Coverages
Coverage Limit
C. Personal property, replacement cost $15,000.00
D. Loss of use $4,500.00
E. Personal liability, each occurrence $100,000.00
F. Medical payments to others, each person $1,000.00
Deductible: $500.00 per occurrence, all covered losses.
Special limits within Coverage C
Property Limit
Bicycles, at the insured location Up to the Coverage C limit
Bicycles, away from the insured location $1,000.00 per bicycle
Portable electronics $2,500.00 per item
Fine art and original artwork $2,000.00 in total
Property used in a business $1,500.00 in total
Cash $200.00
Premium
Item Amount
Annual premium for this policy period, paid in full June 2, $148.00
2025
Change in premium for this amendment $0.00
Renewal offer for the next policy period Sent about 45 days before June 1,
2026
Notes
Reason for amendment: claim LH-CL-0092731, theft of bicycle, August 16, 2025, closed.
Paid $380.00 after the deductible. Replacement bicycle noted at the insured's request.
This policy does not cover flood, earthquake, or damage caused by pets to the rented
premises.
Property used in a business, including computers, tablets and artwork made for sale, is
limited as shown above unless a business property endorsement is added.
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