COI Expires 04/12/2018A Stock Company
P.O. Box 33003
St. Petersburg, FL 33733-8003
WRIG'"'"T
Wright National Flood Insurance Company
FLOOD DECLARATIONS PAGE
RF.X7WAT.
FFL 99.001 1116
4963985
3/13/17
2000 11523 FLD RGLR
Peel 'Number
N IPPoliC Number
Product'T' : standard Pol±CV
09 1150802906 05
1150802906
lGeneral Property Form
Polic Peritxl
Date of issue
A` rat Code
Prior Polk Number
From: 4 12 17 To: 4 12 18 12:01 am Standard Time
1 03 13 2017
1 0087137
109 1150802906 0
Agent (305)294-2542
THE PORTER-ALLEN COMPA
513 SOUTHARD ST
KEY WEST FL 33040-6835
mii_, 2 12017
Finance Dept.
MONROE COUNTY BOARD OF COUNTY
COMMISSIONERS
1111 12TH ST STE 408
KEY WEST FL 33040-3005
Property Location (if other than above) Address may have been changed in accordance with tTSPS standards.
88770 OVERSEAS HWY, PUBLIC WORKS OFFICE, TAVERNIER FL 33070
No Basement
Condo Type: N/A
BUILDING $500,000
CONTENTS $173,800
DEAR MORTGAGEE
The Reform Act of 1994 requires you to notify
the WVO company for this policy within 60 days
of any changes in the servicer of this loan.
The above message applies only when there is a
mortgagee on the insured location.
Premium Paid by: Insured
$2,000 $11,841.00
$2,000 $5,078.00
ANNUAL SUBTOTAL: $16,919.00
DEDUCTIBLE DISCOUNT/SURCHARGE: $.00
ICC PREMIUM: $55.00
COMMUNITY RATING DISCOUNT: $2,546.00
SUB -TOTAL: $14,428.00
RESERVE FUND ASSESSMENT: $2,164.00
PROBATION SURCHARGE: $.00
FEDERAL POLICY SERVICE FEE: $50.00
HFIAA SURCHARGE: $250.00
TOTAL OF PREMIUMS AND FEES: $16,892.00
Pre -FIRM Subsidized
This policy covers only one building. If you have more than one building on your property, please make sure they are all covered. See HL
Property Covered within your Flood policy for the NFIP definition of "building" or contact your agent, broker, or insurance company. Coverage
limitations may apply. Please refer to your Flood Insurance Policy Form for details.
WFL 99.415 0414 0614 FFL 99.310 1012 1010 WFL 99.116 0614 0614
This policy is issued by NAIC company 11523
Wright National Flood Insurance Company A stock company_
Copy Sent To: As indicated on back or additional pages, if any. PatrlciaTempleton-Jones,President
00871370911508029061707202 00004
Insured