| Insurance Coverage Provided by USF&G Specialty Insurance Company | ||||||||
| PRODUCER | ||||||||||
| Valid until: 05/15/2001 | Tel: (305) 387-8920 | |||||||||
| Quote Number: QB00109805 | Fax: (305) 387-8945 | |||||||||
| Homeowners Insurance Coverage | ||||||||||
| Applicant: | Location of Property to be Insured: | |||||||||
| BERNADETTE BARONE | 330 S PENNSYLVANIA AVE | |||||||||
| 330 S PENNSYLVANIA AVE | WINTER PARK, FL 32789-4180 | |||||||||
| WINTER PARK, FL 32789-4180 | ORANGE COUNTY | |||||||||
| Product Type: HO-4 Renter Policy | ||||||||||
| Policy Coverage | Limits | Deductibles | Amount | |||||||
| A - Dwelling | $0 | Section 1 Deductible | $500 | |||||||
| B - Other | $0 | Windstorm / Hail Deductible * | $750 | |||||||
| C - Personal Property | $75,000 | |||||||||
| 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 | $444.00 | ||||||||
| $219.49 | Central Station Alarm Discount | -$22.00 | ||||||||
| Due in 90 days** | Optional Endorsements | $.00 | ||||||||
| $130.60 | State Tax 5% | $22.35 | ||||||||
| Due in 180 days** | FL Surplus Lines Fee | $1.34 | ||||||||
| $130.60 | FL Emergency Fund | $2.00 | ||||||||
| Policy Fee | $25.00 | |||||||||
| Total | $472.69 | |||||||||
| * 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. |
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| For Company Use Only: |
| MA|P|4|1990199019901990|1|NNone|N|1200|0|0|YN|32.59|NNY|Y|B|1| 0|17|24|000000000|B|1|3|N0|0|205|.800|2.7100|444|-22|0|422|472.69 |
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