POLICY CHANGE (5)LexisNexis /FIRSt
PO Box 10680
Peoria, IL 61612 -0680
IMPORTANT:
INSURANCE COVERAGE NOTIFICATION(S)
11111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111
789393 - 285017 -1 -M 01958 S1 /M
CITY OF CLEARWATER
PO BOX 4748
CLEARWATER, FL 33758 -4748
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Total Property Notifications with this Document: 2
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.
November 01, 2013 Notifications may print on back of page and on subsequent pages.
Policy: MUH1007492 REASON: Policy Change Carrier: Modern USA
Insured: GRAY; RAPHAEL -2080 SUN DOWN DR- CLEARWATER -FL -33763 Pol. Type: Homeowners
Mortgagee /Add.Party: CITY OF CLEARWATER ISAOA ATIMA HOUSING DIVISION -PO BOX 4748 - CLEARWATER -FL -33758 Eff. Dte: 10/09/2013
Insurance: West Point Underwriters -PO Box 2800 - Pinellas Park -FL -33780 Pol. From: 11/26/2012Po1. To: 11/26/2013
Producer: Eddie Passmore & Associates -2203 N Hercules Ave - Clearwater -FL -33763 727.210.0522 PremiumAmount: 0.00
Prop. Loc: 2080 SUN DOWN DR- CLEARWATER -FL 33763 Ded. Clausel &2: 1,000 3,140
Loan #:1612
Coverage Coverage Amt Coverage Coverage Amt
Dwelling 157,000 Contents 78,500 This is not an Invoice /Bill
Liability 100,000 Loss of Use 15,700
Med Pay 1,000 Other Structures 3,140
Sinkhole Coverage Excluded Wind & Hail Included
Ordinance or Law Coverage 15,700
Notes: Standard Homeowners Plan FIRSt Id: 12957 -I29- 2918189- 189081428
Policy: MUH1007492 REASON: Policy Change Carrier: Modern USA
Insured: GRAY; RAPHAEL -2080 SUN DOWN DR- CLEARWATER -FL -33763 Pol. Type: Homeowners
Mortgagee /Add.Party: CITY OF CLEARWATER ISAOA ATIMA HOUSING DIVISION -PO BOX 4748 - CLEARWATER -FL -33758 Eff. Dte: 11/26/2013
Insurance: West Point Underwriters -PO Box 2800 - Pinellas Park -FL -33780 Pol. From: 11/26/2013Po1. To: 11/26/2014
Producer: Eddie Passmore & Associates -2203 N Hercules Ave - Clearwater -FL -33763 727.210.0522 PremiumAmount: 1,161.00
Prop. Loc: 2080 SUN DOWN DR- CLEARWATER -FL 33763 Ded. Clausel &2: 1,000 3,140
Loan #:1612
Coverage Coverage Amt Coverage
Dwelling 157,000 Contents
Liability 100,000 Loss of Use
Med Pay 1,000 Other Structures
Sinkhole Coverage Excluded Wind & Hail
Ordinance or Law Coverage 15,700
Notes: Standard Homeowners P1an FIRSt Id: 12957 -I29- 2918189 - 189081430
Page 1 of 1
Coverage Amt
78,500 This is not an Invoice /Bill
15,700
3,140
Included
porn: FL' in
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