POLICY CHANGE SUMMARY (5)kr-r
CITIZEN
S
VFlI)W:fiIY INSIAANCt. CORPORAL ION
CITIZENS PROPERTY INSURANCE CORPORATION
301 W BAY ST
JACKSONVILLE FL 32202
POLICY CHANGE SUMMARY
POLICY NUMBER: 03216564 - 1
POLICY PERIOD FROM 04/10/2019 TO 04/10/2020
at 12:01 a.m. Eastern Time
Transaction: AMENDED DECLARATIONS
Effective: 04/26/2019
Policy Info
Contact Address (Additional Interest: City of Clearwater ISAOAI
ATIMA)
Prior.. Policy Information
Amended Policy Information
Added
Dwelling
Dwelling at 1439 WILSON RD, CLEARWATER, FL
Additional Interests
Additional Interest: City of Clearwater ISAOA/ATIMA
(Additional Interest)
Added
RECEIVED
MAY 132019
OFFICIAL RECORDS AND
LEGISLATIVE SRVCS DEPT,
This summary is for informational purposes only and does not change any of the terms or provisions on your policy. Please
carefully review your policy Declarations and any attached forms for a complete description of coverage.
PCS 01 14
Page 1 of 1
CITIZENS
PHONONS' INSOMNIA. C(IF;KNiAIION
CITIZENS PROPERTY INSURANCE CORPORATION
301 W BAY ST
JACKSONVILLE FL 32202
Homeowners HO -3 Special Form Policy - Declarations
Policy Number: 03216564 - 1 POLICY PERIOD: FROM 04/10/2019 TO 04/10/2020
First Named Insured: Emily Edwards at 12:01 a.m. Eastem lime at the Location of the Residence Premises
Forms and Endorsements applicable to this policy:
CIT HO -3 02 19, HO 04 1604 91, CIT 04 86 08 18, HO 04 10 10 00, CIT 04 96 02 16, CIT 04 85 08 18, CIT 24 07 08
Rating/Underwriting Information
Year Built:
19591
Protective Device - Burglar Alarm:
Yes
Town / Row House:
No
Protective Device - Fire Alarm:
No
Construction Type:
Masonry
Protective Device - Sprinkler:
None
BCEGS:
Ungraded
No Prior Insurance Surcharge:
No
Territory / Coastal Territory:
081 / 00
Terrain:
B
Wind / Hail Exclusion:
No
Roof Cover:
FBC Equivalent
Municipal Code - Police:
251
Roof Cover - FBC Wind Speed:
N/A
Municipal Code - Fire:
251
Roof Cover - FBC Wind Design:
N/A
Occupancy:
Owner Occupied
Roof Deck Attachment:
Level C
Use:
Primary
Roof -Wall Connection:
Clips
Number of Families:
1
'Secondary Water Resistance:
Yes
Protection Class:
1
Roof Shape:
Gable
Distance to Hydrant (ft.):
100Opening
Protection:
None
Distance to Fire Station (mi.):
11
A premium adjustment of ($787) is included to reflect the building's wind loss mitigation features or construction techniques that exists.
A premium adjustment of $0 is included to reflect the budding code effectiveness grade for your area. Adjustments range from a 2%
surcharge to a 13% credit.
The Total Charge For This Endorsement is $0
ADDITIONAL NAMED INSURED(S)
Name Address
INo Additional Named Insureds
ADDITIONAL INTEREST(S)
# Interest Type
1 Additional Interest
2 1st Mortgagee
Name and Address
City of Clearwater ISAOA/ATIMA
112 S OSCEOLA AVE CLEARWATER, FL 33756-5103
Loan Number
RL 1868
QUICKEN LOANS INC ISAOA
PO BOX 202070 FLORENCE, SC 29502-2070
3397893815
DEC HO3 01 19
Additional Interest
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4-
C TIZENS
VNOP9:filY INSU*MICk. C(RKoWli N>N
CITIZENS PROPERTY INSURANCE CORPORATION
301 W BAY ST
JACKSONVILLE FL 32202
Homeowners HO -3 Special Form Policy - Declarations
Policy Number: 03216564 - 1 POLICY PERIOD: FROM 04/10/2019 TO 04/10/2020
First Named Insured: Emily Edwards at 12:01 a.m. Eastern lime at the Location of the Residence Premises
FLOOD INSURANCE: YOU MAY ALSO NEED TO
CONSIDER THE PURCHASE OF FLOOD INSURANCE.
YOUR HOMEOWNER'S INSURANCE POLICY DOES
NOT INCLUDE COVERAGE FOR DAMAGE RESULTING
FROM FLOOD EVEN IF HURRICANE WINDS AND RAIN
CAUSED THE FLOOD TO OCCUR. WITHOUT SEPARATE
FLOOD INSURANCE COVERAGE, YOU MAY HAVE
UNCOVERED LOSSES CAUSED BY FLOOD. PLEASE
DISCUSS THE NEED TO PURCHASE SEPARATE FLOOD
INSURANCE COVERAGE WITH YOUR INSURANCE AGENT.
TO REPORT A LOSS OR CLAIM CALL 866.411.2742
IN CASE OF LOSS TO COVERED PROPERTY, YOU MUST TAKE REASONABLE EMERGENCY MEASURES SOLELY TO PROTECT
THE PROPERTY FROM FURTHER DAMAGE IN ACCORDANCE WITH THE POLICY PROVISIONS.
PROMPT NOTICE OF THE LOSS MUST BE GIVEN TO US OR YOUR INSURANCE AGENT. EXCEPT FOR REASONABLE
EMERGENCY MEASURES, THERE IS NO COVERAGE FOR REPAIRS THAT BEGIN BEFORE THE EARLIER OF: (A) 72 HOURS
AFTER WE ARE NOTIFIED OF THE LOSS, (B) THE TIME OF LOSS INSPECTION BY US, OR (C) THE TIME OF OTHER APPROVAL
BY US.
THIS POLICY CONTAINS LIMITS ON CERTAIN COVERED LOSSES, ALL SUBJECT TO THE TERMS AND CONDITIONS OF YOUR
POLICY. THESE LIMITS MAY INCLUDE A $10,000 LIMIT ON COVERAGE FOR COVERED LOSSES CAUSED BY ACCIDENTAL
DISCHARGE OR OVERFLOW OF WATER OR STEAM FROM SPECIFIED HOUSEHOLD SYSTEMS. SEEPAGE OR LEAKAGE OF
WATER OR STEAM; CONDENSATION, MOISTURE OR VAPOR, AS DESCRIBED AND INSURED IN YOUR POLICY (HEREAFTER
COLLECTIVELY REFERRED TO AS ACCIDENTAL DISCHARGE OF WATER IN THIS PARAGRAPH). AS ANOTHER EXAMPLE,THERE
IS ALSO LIMIT OF $3,000 APPLICABLE TO REASONABLE EMERGENCY MEASURES TAKEN TO PROTECT COVERED PROPERTY
FROM FURTHER DAMAGE BY ACCIDENTAL DISCHARGE OF WATER. THE AMOUNT WE PAY FOR THE NECESSARY REASONABLE
EMERGENCY MEASURES YOU TAKE SOLELY TO PROTECT COVERED PROPERTY FROM FURTHER DAMAGE BY ACCIDENTAL
DISCHARGE OF WATER WILL BE DEDUCTED FROM THE $10,000 LIMIT ON COVERAGE FOR ACCIDENTAL DISCHARGE OF
WATER.
INFORMATION ABOUT YOUR POLICY MAY BE MADE AVAILABLE TO INSURANCE COMPANIES AND/OR AGENTS TO ASSIST
THEM IN FINDING OTHER AVAILABLE INSURANCE MARKETS.
PLEASE CONTACT YOUR AGENT IF THERE ARE ANY QUESTIONS PERTAINING TO YOUR POLICY. IF YOU ARE UNABLE TO
CONTACT YOUR AGENT, YOU MAY REACH CITIZENS AT 866.411.2742.
IDEC H03 01 19
Additional Interest
00
2016 MICHAEL D'AVIRRO
MOODY D'AVIRRO & ASSOCIATES
24626 SR 54 W
LUTZ, FL 33559
CITY OF CLEARWATER ISAOA/ATIMA
112 S OSCEOLA AVE
CLEARWATER, FL 33756-5103
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