Total Loss Control

623 Mound Park Way S, Unit A, St. Petersburg, FL. 33701

Tel: 727-823-2400 Fax: 727-823-2055

Insured: / Phone # : / Case # : 85006
Address: / City: Largo / St.: FL / Zip: 33770
Insp. #: 22 / Policy # / County: Pinellas / Year Built: 1969
Client: / Company: / Coverage: Property
Agent: / Agent #:
Date Requested : / Date Insp.: / Due Date:

Fire Survey

Person Interviewed Title Owners

Insured’s Interest Owner Tenant

Type of business Individual Partnership Corporation Association LLC

Neighborhood Commercial Industrial Rural Residential

Insured’s Operation Assisted living facility

Who occupies building? 10 Senior adults-licensed for 10

Economy Stable Improving Declining

Construction Fire Resistive Non-Comb JM MNC Mod. Fire Res. Frame

Age 1969 Upgraded unknown # Stories 1

Exterior Wall Construction block/stucco

Interior Wall construction drywall

Ceiling Construction drywall

Floor Construction concrete

Upper Floor None

Roof Joists Wood Steel Concrete Other

Roof Covering shingles Observed No Access

Vertical openings Yes No

Reinforced Concrete Wall Yes No Unknown

Hurricane Straps Yes No Unknown

Fire Walls Yes No Unknown

Heating & Cooling HVAC LPG Natural Gas Electric None Other

Type Forced Air Wall Floor Radiant

Hazardous Storage Yes No

Flammables Yes No

Proper Storage Yes No N/A

Wiring Romex Conduit Circuit Breaker Fused

Rewired Yes No If yes, when?

Fire Department largo ISO 3 Paid Volunteer

Distance to Station? less than 5 miles less than 5 mi 5 to 10 mi. over 10 mi.

Hydrant distance 10 ft. Within 500 ft 500 to 1000 ft Not Observed

Private hydrants Yes No

Alternate water source Yes No If yes, describe pond

Previous Losses Yes No If Yes Explain

Fire hoses each floor Yes No

Emergency lights Yes No

Exit signs Yes No

Lighted Yes No

Evacuation routes posted Yes No

Emergency stairs Yes No

Panic bars Yes No

Sprinkler System Yes No Wet Dry Full Partial

Fire Alarm Yes No

Monitored Yes No

Pull Station Alarms Yes No

Smoke Detectors Yes No

Burglar Alarm Yes No

Type of Alarm Motion Entry Heat Smoke Panic

Name of Monitoring Company N/A

Extinguishers Yes No Not observed Tenant supplied

Type ABC Tag Date June 2004 Service Company Piper Fire Protection

PML Building 25 %

PML Contents 35 %

Building Condition Satisfactory Unsatisfactory

Maintenance Satisfactory Unsatisfactory

Trash Removal Satisfactory Unsatisfactory

Flammable Storage Satisfactory Unsatisfactory

Other Hazards No

Distance to Gulf 1 miles Atlantic miles

Grading Excellent Good Average Below Average Poor

Annual Termite Inspections Yes No

COMMERCIAL COOKING (Not applicable)

AES over Cook Stove Yes No

Filters Clean Yes No

Hood Clean Yes No

Name

Tag Date

Service Company

Cleaning Schedule

Cleaning Contractor

BUILDING VALUES

DIAGRAM Yes No No Access See Diagram Page

CONTENTS - Required

Furniture $30,000 Stock 0 Total Value $30,000

RATING BASIS - Required

Number of employees 5 Payroll $2,500-$3,000 per week Gross Sales Receipts $250,000-$300,000

Comments

Recommendations No Yes See recommendations page

This report was made only from visual observations and/or verbal interviews. Total Loss Control assumes no legal responsibility for misinformation given to the inspector at the time of the survey, nor should it be implied that there are no other deficiencies on site that may not have been observed by the inspector. We also assume no liability for delayed reports. All of the information is for underwriting purposes only and not intended for any other use.

DIAGRAM

TLC Total Loss Control 85006

Insured:

Policy #:

Address:
City: Largo / St. FL / Zip. 33770

Commercial Building Valuation Report

Policy: 85006 5/05/2006

INSURED Effective Date:

Expiration Date:

Largo, FL 33770 Cost as of: 12/2005

BUILDING

Largo, FL 33770

SECTION 1

Superstructure

Occupancy: 100% Multiple Residence, Assisted Liv Story Height: 9 ft.

Construction Type: 100% Masonry Number of Stories: 1

Gross Floor Area: 4,472 sq.ft. Irregular Adjustment: None

Construction Quality: 2 - Average

Year Built: 1969

Adjustments

Depreciation: 13% Effective Age: 10 years Condition: Good

SUMMARY OF COSTS Replacement

SUPERSTRUCTURE

Site Preparation 672

Foundations 33,858

Foundation Walls, Interior Foundations, Slab On Ground

Exterior 113,279

Framing, Exterior Wall, Structural Floor, Roof

Interior 55,836

Floor Finish, Ceiling Finish, Partitions

Mechanicals 116,979

Heating, Cooling, Fire Protection, Plumbing, Electrical, Elevators

Built-ins 30,855

SUBSTRUCTURE

TOTAL RC SECTION 1 $351,477

TOTAL ACV Depreciated Cost (87%) $305,785

TOTAL RC BUILDING 945 7th Ave NW $351,477

TOTAL ACV $305,785

Replacement $/sq.ft. Depreciated $/sq.ft.

VALUATION GRAND TOTAL $351,477 $78.60 $305,785 $68.38

INSURED Effective Date:

Expiration Date:

Largo, FL 33770 Cost as of: 12/2005

BUILDING : Superstructure Replacement sq.ft. $/sq.ft. Depreciated

Section 1: 100% Multiple Residence, Assisted Liv $351,477 4,472 $78.60 $305,785

BUILDING : Substructure Replacement sq.ft. $/sq.ft. Depreciated

Section 1: $0 0 $0.00 $305,785

Section Totals Replacement sq.ft. $/sq.ft. Depreciated

Section 1: 100% Multiple Residence, Assisted Liv $351,477 4,472 $78.60 $305,785

VALUATION GRAND TOTAL $351,477 4,472 $78.60 $305,785

MS/B costs include labor and material, normal profit and overhead as of date of report. Costs represent general estimates which are not to be considered a detailed quantity survey. These costs include generalities and assumptions that are common to the types of structures represented in the software.

RECOMMENDATIONS PAGE

Insured

We have conducted a loss control inspection of the above property. In our inspection we have noted the following hazards that need to be addressed:

1. It is recommended that a licensed fire extinguishing company be contacted to annually inspect and service fire extinguishers in accordance with NFPA standard, #10. Future maintenance on all extinguishers should be performed at least annually and a durable tag should be attached to the unit to indicate the date of inspection and recharge.

2. It is recommended that exit signs and or exit lights be affixed near the doors to assist in an emergency exit as required by NFPA Life Safety Code #101.

Please advise us as to the compliance of these recommendations within days.

These recommendations concern conditions seen at the time of the inspection. Total Loss Control assumes no legal liability for misinformation given to the inspector at the time of the visit, nor should it be implied that there are no other deficiencies on site that might not be seen by the inspector. We assume no liability for the delayed reports. All information is for underwriting purposes and must be held in strict confidence.