USA INSURANCENET.COM PREPARED FOR: Ronald W. Bush
ONLINE ACCESS HOMEOWNERS QUOTE
         
  Insurance Coverage Provided by USF&G Specialty Insurance Company
            PRODUCER  
  Valid until: 01/06/2001     Tel: (954) 927-0255  
  Offer number: QJ00006123   Fax: (954) 923-8499  
                   
  Homeowners Insurance Coverage        
                   
  Applicant:   Location of Property to be Insured:  
  RONALD W. BUSH   1365 RILA ST SE    
  1365 RILA ST SE   PALM BAY, FL. 32909-6432    
  PALM BAY, FL. 32909-6432   BREVARD COUNTY    
                 
  Product Type: HO-3 Homeowner Policy      
             
  Policy Coverage Limits   Deductibles Amount  
  A - Dwelling $145,000   Section 1 Deductible $1,000.00  
  B - Other $14,000   Windstorm / Hail Deductible * $4,350.00  
  C - Personal Property $101,500          
  D - Loss of Use $29,000          
  E - Personal Liability $300,000          
  F - Med Pay to Others $2,000          
                   
  Three Pay   Annual  
  Due Now (Down Payment)   Base Premium   $925.00  
  $426.51   Central Station Alarm Discount -$46.00  
  Due in 90 days**     Optional Endorsements $.00  
  $267.70   State Tax 5% $45.20  
  Due in 180 days**     FL Surplus Lines Fee $2.71  
  $267.70   FL Emergency Fund $2.00  
          Policy Fee $25.00  
      Total   $953.91  
  * 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|5|2000200020002000|1|NNone|N|2700|0|0|YY|3.5|NNY|Y|C|5|0|17|
24|000000000|A|1|3|N167000|63|560|.800|1.9500|874|-131|0|743|810.7
   
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