Allstate Vehicle and Property Insurance Company

This Endorsement Changes Your Policy- Keep It with Your Policy

Building Structure Exclusion
______________________________________________________________________
Coverage B Other Structures Protection is changed as follows:
It is agreed that the following building structure(s) at your residence premises is (are) not covered under
Section I of this policy:

Schedule Other Structures Description

Location of Building
1. _________________________________

Construction
_________________________

Building Use
_________________________

_________________________________________________________________________________________________
2. _________________________________

_________________________

_________________________

_________________________________________________________________________________________________
3. _________________________________

_________________________

_________________________

_________________________________________________________________________________________________
4. _________________________________

__________________________

_________________________

_________________________________________________________________________________________________
5. _________________________________

__________________________

_________________________

_________________________________________________________________________________________________
This endorsement is effective from _________________, 20____ at

12:01 a.m.

12:00 noon standard time,

and forms a part of policy number ___________________________ issued to ________________________________ .

Signed____________________________________
Insured

Signed_______________________________________
Insured

Date _____________________________________

Date ________________________________________

AVP180