| Insurance Coverage Provided by USF&G Specialty Insurance Company | ||||||||
| PRODUCER | |||||||||
| Quote Valid until: 02/12/2001 | Tel: (954) 927-0255 | ||||||||
| Offer number: QJ00023267 | Fax: (954) 923-8499 | ||||||||
| Homeowners Insurance Coverage | |||||||||
| Applicant: | Location of Property to be Insured: | ||||||||
| STEVE PATTERSON | 148 ISLE OF VENICE DR APT 1 | ||||||||
| 148 ISLE OF VENICE DR APT 1 | FORT LAUDERDALE, FL. 33301-1460 | ||||||||
| FORT LAUDERDALE, FL. 33301-1460 | BROWARD COUNTY | ||||||||
| Product Type: HO-4 Renter Policy | |||||||||
| Policy Coverage | Limits | Deductibles | Amount | ||||||
| A - Dwelling | $0 | Section 1 Deductible | $500.00 | ||||||
| B - Other | $0 | Windstorm / Hail Deductible * | N/A | ||||||
| C - Personal Property | $25,000 | ||||||||
| D - Loss of Use | $10,000 | ||||||||
| E - Personal Liability | $300,000 | ||||||||
| F - Med Pay to Others | $2,000 | ||||||||
| Three Pay | Annual | ||||||||
| Due Now (Down Payment) | Base Premium | $303.00 | |||||||
| $144.75 | Age of Structure | $30.00 | |||||||
| Due in 90 days** | |||||||||
| $81.10 | Optional Endorsements (x-wind) | -$76.00 | |||||||
| Due in 180 days** | State Tax 5% | $14.10 | |||||||
| $81.10 | FL Surplus Lines Fee | $.85 | |||||||
| FL Emergency Fund | $2.00 | ||||||||
| Policy Fee | $25.00 | ||||||||
| Total | $298.95 | ||||||||
| * 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|3|1960198019801980|1|YInGround|N|3865|0|0|NY|1.06|YY|N|B|0| 0|17|24|000000000|A|1|1|N0|0|379|.800|1.0000|303|30|-76|257|298.95 |
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