INSURANCE COVERAGE NOTIFICATIONSLexisNexis /FIRSt
PO Box 10680
Peoria, IL 61612 -0680
IMPORTANT:
INSURANCE COVERAGE NOTIFICATION(S)
I NII II I IIII IIIII I IN I IN IIIII III 111111 I IIII III II IIIII I III 1111 III 111111 IIII IIIIIIII 11111
725516 - 285017 -1 -M 03943 S1 /M
CITY OF CLEARWATER
PO BOX 4748
CLEARWATER, FL 33758 -4748
1111111 .11111111111111111"1111111 111111111111111111111111111.11
Total Property Notifications with this Document: 2 June 10, 2013
LexisNexis is not the Insurance Company.
Do not send premium payments to LexisNexis / FIRSt.
- For any and all policy changes you must contact the Insurance
Company, Carrier, or Producer listed in the detail below.
- For all cancellation, non - renewal, expiration, and lapse notices -
all coverage will cease at 12:01AM local time at the premises,
unless otherwise shown in the item detail provided.
- Premium Bill and Renewal Bill items require action on the part of
the Loss Payee /Mortgagee listed.
- If you want to receive future notifications electronically, email
firstsupport@lexisnexis.com.
- This Insurance notice is sent to you as the Loss
Payee /Mortgagee /Additional Interested Party on behalf of the
carrier listed.
Notifications may print on back of page and on subsequent pages.
Policy: HPH027995 REASON: Renewal Notification
Insured: RILEY; ALFONSA NICOLE RILEY -1104 S SAN REMO AVE - CLEARWATER -FL -33756
Mortgagee /Add.Party: CITY OF CLEARWATER ISAOA ATIMA -PO BOX 4748 - CLEARWATER -FL -33758
Insurance: West Point Underwriters -PO Box 2800 - Pinellas Park -FL -33780
Producer: DENNIS INSURANCE AGENCY INC. -209 CRYSTAL GROVE BLVD. #101 - LUTZ -FL -33548 813
Prop. Loc: 1104 S SAN REMO AVE - CLEARWATER -FL 33756
Loan #:
Coveraae Coveraae Amt Coveraae
Dwelling 195,000 Contents
Liability 100,000 Loss of Use
Med Pay 2,000 Other Structures
Sinkhole Coverage Excluded Wind & Hail
Ordinance or Law Coverage 48,750
Notes: Standard /Takeout HT3FIRSt Id: -I29- 747357- 171164796
Carrier: Heritage Property and Casualty Insurance Cornpany
Pol. Type: Homeowners
Eff. Dte: 07/30/2013
Pol. From: 07/30/2013PoI. To: 07/30/2014
.949.6480 PremiumAmount: 1,552.00
Ded. Clausel &2: 2,500 9,750
Coveraae Amt
48,750 This is not an Invoice /Bill
19,500
Included
Included
Policy: HPH028564 REASON: Renewal Notification
Insured: HALL; STEPHANIE -1250 FORREST HILL DR- CLEARWATER -FL -33756
Mortgagee /Add.Party: CITY OF CLEARWATER ISAOA ATIMA -PO BOX 4748- CLEARWATER -FL -33758
Insurance: West Point Underwriters -PO Box 2800 - Pinellas Park -FL -33780
Producer: KEY PALM INSURANCE -PO BOX 16943 - CLEARWATER -FL -33766 727.796.1312
Prop. Loc: 1250 FORREST HILL DR- CLEARWATER -FL 33756
Loan #:
Coveraae Coveraae Amt Coveraae
Dwelling 125,000 Contents
Liability 100,000 Loss of Use
Med Pay 2,000 Other Structures
Sinkhole Coverage Excluded Wind & Hail
Ordinance or Law Coverage 31,250
Notes: Standard /Takeout HT3 FIRSt Id: -I29- 747357- 171165994
Page 1 of 1
Carrier: Heritage Property and Casualty Insurance Cornpany
Pol. Type: Homeowners
Eff. Dte: 08/01/2013
Pol. From: 08/01 /2013PoI. To: 08/01/2014
PremiumAmount: 1,091.00
Ded. Clausel &2: 2,500 6,250
Coveraae Amt
31,250 This is not an Invoice /Bill
12,500
Included
Included