RENEWAL NOTIFICATION (15)LexisNexis is not the Insurance
Company.
For any and all policy changes you
must contact the Insurance Company,
the Carrier or the Producer listed in
the detail below.
If you are not the intended recipient,
please return this card.
RECENED
RI 3 1 2015
OFFICIAL � p pT
LEA
IMPORTANT: INSURANCE COVERAGE NOTIFICATION(S)
LexisNexis is not the Insurance Company.
Do not send premium payments to LexisNexis /FIRSt.
I 0
Place
Stamp
Here
1092015- 285017 -1 4
LexisNexis /FIRSt
2885 Breckinridge Blvd, Ste 400
Duluth, GA 30096
-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.
-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.
Policy: OLT0012566 REASON: Renewal Notification Eff. Dte: 09/17/2015
Pol. Type:Homeowners Pol. From: 09/17/2015PoI. To: 09/17/2016
Carrier: Olympus Insurance Company Loan #: DPA -1476
Prop. Loc: 1633 Harvard St- Clearwater -FL 33755
End.No. /State: OLHO100 -FL 1 OLHO140 -FL 1 H00448 -FL
Insured: Kurtovic Emsud Kurtovic Medina -1633 Harvard St- Clearwater -FL -33755
Mortgagee /Add.Party: City of Clearwater Isaoa Atima -PO Box 4748 - Clearwater -FL -33758
Insurance: Olympus lnsurance Company -7380 W Sand Lake Road Suite 115 - Orlando -FL -32819
Producer: Katherine Jones Insurance Agency Inc -575 S Hercules Avenue #604 - Clearwater -FL -33764 727.447.8989
Coverage Coveraae Amt/Deduct Coverage Coveraae Amt/Deduct PremiumAmount: 0.00
Dwelling 148,000/2,500 Other Structures 2,960/2,500 Total Policy Prernium:1,690.00
Personal Property 37,000/2,500 Loss of Use 14,800/2,500
Liability 100,000/0 Med Pay 2,000/0
Earthquake EXCL Hurricane 148,000/7,400
Sinkhole Coverage EXCL
Notes: H03; Spec Provs -FL; Cat Ground Cover Coll; Inc Lim -Oth Struct $4440 FIRSt Id:
12954 -I185- 747357 - 271175519