Loading...
EVIDENCE OF PROPERTY INSURANCE OP ID: L5 ACt7R©`' DATE(MM/DD/YYYY) EVIDENCE OF PROPERTY INSURANCE 02/19/2013 THIS EVIDENCE OF PROPERTY INSURANCE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE ADDITIONAL INTEREST NAMED BELOW. THIS EVIDENCE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS EVIDENCE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE ADDITIONAL INTEREST. AGENCY PHONE 727-461-6044 COMPANY A/C Ext: National Casualty Company Brown&Brown of Florida, Inc.c. Y p Y 83 Park Place Blvd.,Ste 101 One West Nationwide Blvd P.O. Box 2456(33757-2456) Columbus, OH 43215-2220 Clearwater, FL 33759 Sean Tobe FAX No:727-442-7695 ADDRIESS: CODE: SUB CODE: AGENCY CHICH-2 CUSTOMER ID#: INSURED Chi Chi Rodriguez Youth LOAN NUMBER POLICY NUMBER Foundation, Inc.and The First TBD 3030 McMullen Booth Rd EFFECTIVE DATE EXPIRATION DATE Clearwater, FL 33761 CONTINUED UNTIL 02/01/13 02/01/14 TERMINATED IF CHECKED THIS REPLACES PRIOR EVIDENCE DATED: PROPERTY INFORMATION LOCATION/DESCRIPTION 3030 McMullen Booth Rd Clearwater, FL 33761 THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS EVIDENCE OF PROPERTY INSURANCE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. COVERAGE INFORMATION COVERAGE/PERILS/FORMS AMOUNT OF INSURANCE DEDUCTIBLE Special form RC See schedule for locations **Wind&Hail Deductible 5% **All Other Perils Deductible 5000 REMARKS(including Special Conditions CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. ADDITIONAL INTEREST NAMEANDADDRESS MORTGAGEE ADDITIONAL INSURED LOSS PAYEE LOAN# City of Clearwater P O Box 4748 AUTHORIZED REPRESENTATIVE Clearwater, FL 33756-5520 ACORD 27(2009/12) ©1993-2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD