USA INSURANCENET.COM PREPARED FOR: Robert Mensch
ONLINE ACCESS HOMEOWNERS QUOTE
         
  Insurance Coverage Provided by USF&G Specialty Insurance Company
            PRODUCER  
  Valid until: 05/04/2001     Tel: (305) 387-8920  
  Offer number: QB00096010   Fax: (305) 387-8945  
                   
  Homeowners Insurance Coverage        
                   
  Applicant:   Location of Property to be Insured:  
  ROBERT MENSCH   397 MADONNA BLVD.    
  397 MADONNA BLVD.   TIERRA VERDE, FL. 33715-1738    
  TIERRA VERDE, FL. 33715-1738   PINELLAS COUNTY    
                 
  Product Type: HO-3 Homeowner Policy      
             
  Policy Coverage Limits   Deductibles Amount  
  A - Dwelling $150,000   Section 1 Deductible $1,000.00  
  B - Other $15,000   Windstorm / Hail Deductible * $7,500  
  C - Personal Property $105,000          
  D - Loss of Use $30,000          
  E - Personal Liability $300,000          
  F - Med Pay to Others $2,000          
                   
  Three Pay   Annual  
  Due Now (Down Payment)   Base Premium   $867.00  
  $460.49   Age of Structure $87.00  
  Due in 90 days**     Storm Shutter Surcharge $43.00  
  $290.20   Central Station Alarm Discount -$43.00  
  Due in 180 days**     Optional Endorsements $.00  
  $290.20   State Tax 5% $48.95  
            FL Surplus Lines Fee $2.94  
          FL Emergency Fund $2.00  
            Policy Fee   $25.00  
      Total $1,032.89  
  * When windstorm/hail deductible
displays N/A and endorsement HO-04-94
is attached to the policy, the perils
of windstorm and hail are excluded.
Make check payable to Hull & Company, Inc.    
  ** $4.00 installment fee included        
         
Coverage is conditional upon: 1) receipt of correct premium; and 2) insured's signature on the Homeowner Application.
If check is returned for insufficient funds, no coverage shall take effect. The effective date of coverage is 12:01 AM the day
coverage is bound. Future effective dates can be specified. If you desire an effective date in the future, please specify:
______________________ at 12:01 AM.
For Company Use Only:
MA|P|2|1961199319931993|1|YInGround|N|2346|0|0|YN|0.2|NNY|Y|C|5|0|
17|24|000000000|B|1|2|N115000|64|586|.800|1.8500|867|87|0|954|1032.89
   
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