| Insurance Coverage Provided by USF&G Specialty Insurance Company | ||||||||
| PRODUCER | |||||||||
| Quote Valid until: 05/20/2001 | Tel: (305) 387-8920 | ||||||||
| Quote Number: QB00113890 | Fax: (305) 387-8945 | ||||||||
| Homeowners Insurance Coverage | |||||||||
| Applicant: | Location of Property to be Insured: | ||||||||
| VENITA HAMES | 2714 NW 48TH ST. | ||||||||
| 2714 NW 48TH ST. | TAMARAC, FL. 33309-2939 | ||||||||
| TAMARAC, FL. 33309-2939 | BROWARD COUNTY | ||||||||
| Product Type: HO-3 Homeowner Policy | |||||||||
| Policy Coverage | Limits | Deductibles | Amount | ||||||
| A - Dwelling | $70,000 | Section 1 Deductible | $1,000.00 | ||||||
| B - Other | $7,000 | Windstorm / Hail Deductible * | $7,000.00 | ||||||
| C - Personal Property | $49,000 | ||||||||
| D - Loss of Use | $14,000 | ||||||||
| E - Personal Liability | $300,000 | ||||||||
| F - Med Pay to Others | $2,000 | ||||||||
| Three Pay | Annual | ||||||||
| Due Now (Down Payment) | Base Premium | $1,171.00 | |||||||
| $558.79 | AOP deductible surcharge | -$117.00 | |||||||
| Due in 90 days** | Age of Structure | $117.00 | |||||||
| $355.30 | Optional Endorsements | $.00 | |||||||
| Due in 180 days** | State Tax 5% | $59.80 | |||||||
| $355.30 | FL Surplus Lines Fee | $3.59 | |||||||
| FL Emergency Fund | $2.00 | ||||||||
| Policy Fee | $25.00 | ||||||||
| Total | $1,261.39 | ||||||||
| * 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|5|1967198019801980|1|NNone|N|1143|0|0|NY|5.2|NNY|N|C|A|0|17 |24|000000000|B|1|2|N70000|57|1464|.800|1.0000|1171|0|0|1171|1261.39 |
| NOTES: Coverage for Recreational Vehicles are not included in this quote. Coverage for | |
| other owned, occupied, leased, or rented properties are not included in this quote. | |
| Make sure to print this page before you continue |
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