COI Expires 04/12/2018A Stock Company
P.O. Box 33003
St. Petersburg, FL 33733-8003
WRI(_M`1T
Wright National Flood Insurance Company ,
FLOOD DECLARATIONS PAGE
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FFL 99.001 1116
4964072
3/13/17
2000 11523 FLD RGLR
Poliry'Nuimber
I NFIP'Policy Numbex:
"Product Tpue:
Standard Policy
09 1150802904
05
1150802904
lGeneral
Property
Form
Pokey Period I
Date of issue
I A=nt,-C1Dde I
Prior Policy Number
From: 4/12/17 To: 4/12/18 12:01 am Standard Tune
1 03/13/20171
0087137
109 1150802904 0
Agent (305)294-2542
THE PORTER-ALLEN COMPANY INC
513 SOUTHARD ST
KEY WEST FL 33040-6835
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 LISPS standards.
3491 S ROOSEVELT BLVD, BOYS AND GIRLS ZLUB, KEY WEST FL 33040
1= a Informire I
Original New'Business Effective Dater 4/12/2012
Building Occupancy: Business Community Name: KEY WEST, CITY OF
Primary Residence: N Community #: 120168 Map Panel/Suffix: 1517 K
Number of Floors: One Floor Community Rating: 07 / 15%
Building Indicator: Non -Elevated Program Status: Regular Grandfathered: No
Basemient/Enclosure/Crawlspace: Flood Risk/Rated Zone: VE
No. Basement
Condo Type: N/A
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the WYO 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
RESERVE FUND ASSESSMENT: $3,365.00
PROBATION SURCHARGE: $.00
FEDERAL POLICY SERVICE FEE: $50.00
HFIAA SURCHARGE: $250.00
TOTAL OF PREMIUMS AND FEES: $26,098.00
LS06dai P.rovisrn� ,77
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 IIL
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 P,2;6�'
Copy Sent To: As indicated on back or additional pages, if any. Patricia Templeton -Jones, President
00871370911508029041707202 00002
Insured
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