| 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 |
| Make sure to print this page before you continue | |
| DID YOU LIKE OUR QUOTE? | |