RENEWAL NOTIFICATION AND POLICY CHANGELexisNexis /FIRSt
PO Box 11563
Milwaukee, WI 53211 -0563
IMPORTANT:
INSURANCE COVERAGE NOTIFICATION(S)
1111111 11111 1011 0111 0111 01110111 1111 111111 0111 0111 0111 0111 0111 1111 111111 1111 011111111 1111
1337089 - 285017 -1 -M 09841 S1 /M 42
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.
RECEIVED
NOV 1 A 2116
OFFICIAL RECORDS AND
!-EGISLATIVE SRVCS DEPT
November 07, 2016 Notifications may print on back of page and on subsequent pages.
Policy: 0L30016656 REASON: Renewal Notification
Insured: LYNN P BOATWRIGHT -1140 WILLIAMSON LN- CLEARWATER -FL -33756
Mortgagee /Add.Party: THE CITY OF CLEARWATER CITY OF CLEARWATER -PO BOX 4748 - CLEARWATER -FL -33758
Insurance: Olympus Insurance Company -P.0. Box 32879 -Palm Beach Gardens -FL -33420
Producer: HOMEOWNERS INS AGENCY INC -2240 BELLEAIR RD SUITE 200 - CLEARWATER -FL -33764 727.216.6310
Prop. Loc: 1140 WILLIAMSON LN- CLEARWATER -FL 33756
End.No. /State: OLHO 100 - I OLHO 140 -
Loan #:ATTN: T.M.SMITH
Coverage
Dwelling
Personal Property
Liability
Notes: H03; Spec Provs -FL; Cat Ground
Carrier: OLYMPUS INSURANCE COMPANY
Pol. Type: Homeowners
Eff. Dte: 12/29/2016
Pol. From: 12/29/2016PoI. To: 12/29/2017
Ded. Clause1&2: 1,000 2%
Coverage Amt Coverage Coverage Am(
207,490 Other Structures 4,150 This is not an Invoice /Bill
103,744 Loss of Use 20,749
300,000 Med Pay 2,000
Cover Coll; Sinkhole Coy Excluded FIRSt Id: 12954 -I121- 4613289- 340013386
Policy: SFIH1265974 -01 -0500 REASON: Policy Change Carri
Insured: WILLIAMS;VAN -608 BROOKSIDE DR- CLEARWATER -FL -33764
Mortgagee /Add.Party: CITY OF CLEARWATER -PO BOX 4748 ISAOA / ATIMA- CLEARWATER -FL -33758
Insurance: SECURITY FIRST INSURANCE COMPANY -P.O. BOX 45- 9025 - SUNRISE -FL- 33345 -Ph: 386.523.2361
Producer: FLORIDA BEST QUOTE -801 WEST BAY DRIVE STE 102 - LARGO -FL -33770 727.584.9999
Prop. Loc: 608 BROOKSIDE DR- CLEARWATER -FL 33764
Loan #:
Coverage Coverage Amt Coverage
Dwelling 133,435 Other Structures
Notes: Flood Coverage excluded Dedl-= AOPDed Ded2=HurrDedFIRSt Id: 10117 -I85- 285017- 339994240
er: SECURITY FIRST INSURANCE COMPANY
Pol. Type: Homeowners
Eff. Dte: 11/04/2016
Pol. From: 09/15/2016PoI. To: 09/15/2017
PremiumAmount: 0.00
Ded. Clause1&2: 2,500 2,669
Page 1 of 1
Coverage Amt
2,669 This is not an Invoice /Bill