Property Inspection Checklist Property Owner Property Address Sample Exterior Property Address 10100 Hwy 59 City/St/Zip Evansville, WI 53515 Insurance Carrier WIAMPC001 - Ampul Policy Number & Date 1234 4/12/2017 *The property is located on a rural highway between Edgerton and Evansville WI. The property consists of a new dwelling still being completed and landscaped, and several outbuildings and grain bins, and finally an older uninhabited dwelling. Overall Risk Grade A B C D F * This report reflects the inspection of the uninhabited dwelling on the property. The newer dwelling and outbuildings are included in the following report. Report Type Home Farm Was the insured interviewed? Yes (persons name) No * Insured. Is the property vacant? Yes No U/D Nearest Fire Hydrant <100 ft 100-500 ft >1000 ft None Nearest Resonding Fire Station < 1 Mile 1- 5 Miles Dwelling Information Approximate Sq. Ft.: 1600 sq. ft. > 5 Miles # of Stories: 1 Approximate Age: 80 yrs.+ 1 1/2 2 2 1/2 3 Tri-Level Bi-Level Other (state type) Below Grade Basement Crawl Slab Open Foundation Piers Dwelling Condition Very Good Good Average Fair Poor Central Air Yes No * Window units Garage Type Attached Detached * None Roof Type Asphalt Shingle Metal Rolled Roofing Cedar Shake Rubber Other Roof Age 0-5 years 6-12 12-18 19+

Electrical Service Size Roof Condition Very Good Good Average Fair Poor Siding Type Vinyl Alum Wood Hard Board Brick (Veneer) Brick (solid) Asbestos Slate Log Other (state type) Siding Condition Very Good Good Window Condition Average Fair Poor Electrical Service Size 60 AMP 100 AMP 200 AMP 400 AMP Unable to Determine * Service on the pole, appears to be 100 amp by service drop. Electrical Service Condition Very Good Good Type Of Furnace Natural Gas Propane Oil Electric Other Evidence of Solid Fuel Yes No U/D Hot Tub Yes No U/D Pool Yes No U/D Trampoline Yes No U/D Yard Maintenance Very Good Good Average Fair Poor Trip Fall Hazards Yes (see photo) No * There is a concrete patio that is over 21" and has no railing. There ios also a 2nd floor exit onto the roof where a railing is missing. Dogs on Property Yes No # of Dogs Breed: Nature of Dog's Friendly Number: Pleasant Protective Aggressive Attack if it Could Unable to Determine (inside or barking) Horses Yes No U/D N/A Horses on Property Number: None Business on Premises Yes (type & name if known) No Unknown

Overall Property Impression 1 2 Action Needed 3 4 5 6 7 8 9 10 Yes (describe) No Follow-Up * 1) Review policy for coverage on the dwelling being vacant at this time. Recommend that if the dwelling is going to be inhabited again that proper railings be installed at the concrete patio and 2nd floor exit, or make the exit inoperable to prevent exit onto the roof. Consider reduced or reducing coverage on the roof due to age and conditions. Consider reduced or reducing coverage on the siding due to age and conditions. Recommend that the bushes and shrubbery be trimmed back away from the dwelling to prevent damage to the structure. Review policy for coverage and charges for the play set if appicable

Electrical Service Size Property Owner Sample Exterior Property Address 10100 Hwy 59 City/St/Zip Evansville, WI 53515 Insurance Carrier WIAMPC001 - Ampul Policy Number & Date 1234 4/12/2017 *This report reflects the findings for the new dwelling on the property. Overall Risk Grade A B Dwelling Information Approximate Sq. Ft.: 2528 sq. ft. C D F Approximate Age: New, being completed, and landscaing has not been completed Approximate Replacement Cost: $316,736.00 # of Stories: 1 1 1/4 Dwelling Condition Very Good Good Below Grade Basement Crawl Central Air Yes No Garage Type Attached Detached Roof Type Asphalt Shingle Metal Roof Age 0-5 years 6-12 Roof Condition Siding Type Vinyl Alum Wood * Steel type panels on a section of the dwelling. Siding Condition Window Condition 1 1/2 1 3/4 2 2+ Average Fair Poor Slab Rolled Roofing Cedar Shake Other 12-18 19+ Average Fair Poor Hard Board Brick (Veneer) Brick (solid) Asbestos Slate Other (State Type if Know) Average Fair Poor Very Good Electrical Service Size Good Average Fair Poor 60 AMP 100 AMP 200 AMP 400 AMP Unable to Determine Electrical Service Condition Type Of Furnace Natural Gas Propane Oil Electric Other Evidence of Solid Fuel Yes No U/D

Pool Features Check all that apply! Hot Tub Yes No U/D Pool Yes No Pool Features Check all that apply! Fence Locked Gate U/D Walk-on Cover Slide Removable Ladder Diving Board Other (State Type if Know) Trampoline Yes No U/D Yard Maintenance Very Good Good Average Fair Poor * Finish landscaping in progress. Side Walk Conditions Very Good Good Average Fair Poor * In progress. Other Trip Fall Hazards Yes No * At time of inspection the finish railings had not been installed at the from porch and permanent steps had also not been installed. Dogs on Property Yes No # of Dogs Breed: Nature of Dog's Friendly Number: Pleasant Protective Aggressive Attack if it Could Unable to Determine (inside or barking) Horses Yes No U/D N/A Horses on Property Livestock on Property Yes Number: None No Fencing Condition Very Good Good Average Fair Poor * NA Silos on Property Yes No * 3 large grain bins and loader. # of Silos on Property Silos on Property: none Farm Machinery on Site Yes No Business on Premises Yes No Unknown Is the Property Vacant? Yes No U/D

Overall Property Impression 1 2 Overall Personal Impression 3 4 5 6 7 8 9 10 3 4 5 6 7 8 9 10 No One Home at Time of Survey Action Needed Yes No Follow-Up * 1) Consider reduced or reducing coverage on OB 1 & 3 due to age and conditions of framing and roofing. NOTE: Building 1 has noticeable sag in rafters and bow in roof not captured in photographs. 2) Consider follow-up inspection to check on progress of landscaping and installation of required railings and steps.

Out Building Information Type RCE Width Length Electrical Condition Outside Roof Collapse Risk Building 1 Machine shed 28 70 ave ave/fair fair/poor Yes Building 2 Scale building 6 8 no Building 3 Grain sorting 30 NATT Building 4 Shed 1 24 40 Building 5 Shed 2 16

Location Drawing (Not to Scale)

Address Verification Front Front

Front Front/Side Side

Rear Rear Side

Side Side / Front Side / Front

Front porch railing not yet installed Rear exit from Garage Temporary steps to front porch

Roof condition (very good) Propane tank Electrical meter

Propane service entry Front Side

Side / Front Side Rear/ Side

Rear Side /Rear Siding Condition (ave/fair)

Side Front/Side 2nd floor exit (railings removed)

Electrical meter Play set Roof condition (ave/fair)

Porch missing rail Propane tank Outbuilding 1 & 2

Outbuilding 1 Outbuilding 1 Outbuilding 1

Outbuilding 1 & 2 OB 1 electrical panel Tie collar joint OB 1

Outbuilding 1 & 2 & 3 Outbuilding 1 & 3 Outbuilding 4

Outbuilding 4 Outbuilding 4 Outbuilding 4 & 5

Unsecured electrical box OB 1 Grain bins Grain bin