Loading...
HomeMy WebLinkAboutInsurance Policy 011824DATE (MM/DD/YYYY) PHONEAGENCY COMPANY(A/C,No,Ext): FAX E-MAILADDRESS: CODE: AGENCY INSURED LOAN NUMBER POLICY NUMBER EFFECTIVE DATE EXPIRATION DATE THIS REPLACES PRIOR EVIDENCE DATED: LOCATION/DESCRIPTION COVERAGE / PERILS / FORMS DEDUCTIBLE NAME AND ADDRESS AUTHORIZED REPRESENTATIVE MORTGAGEE LOAN # PROPERTY INFORMATION COVERAGE INFORMATION REMARKS (Including Special Conditions) CANCELLATION ADDITIONAL INTEREST ACORD 27 (2016/03) The ACORD name and logo are registered marks of ACORD EVIDENCE OF PROPERTY INSURANCE LOSS PAYEEADDITIONAL INSURED LENDER'S LOSS PAYABLE © 1993-2015 ACORD CORPORATION. All rights reserved. AMOUNT OF INSURANCE BASIC BROAD SPECIALPERILS INSURED TERMINATED IF CHECKED CONTINUED UNTIL CUSTOMER ID #: (A/C, No): SUB CODE: Travelers Personal Insurance PO Box 660307 Dallas, TX 75266-0307 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS EVIDENCE OF PROPERTY INSURANCE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. THIS EVIDENCE OF PROPERTY INSURANCE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE ADDITIONAL INTEREST NAMED BELOW. THIS EVIDENCE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS EVIDENCE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE ADDITIONAL INTEREST. 2,500 258,000 25,800 2,141 25,800 500,000 5,000 01/16/2024 (501) 661-4800 MCGRIFF INS SERVICES LLC 500 PRESIDENT CLINTON AVE LITTLE ROCK, AR 72201 (501) 978-8407 0TJ138 TRAVELERS PERSONAL INSURANCE COMPANY ONE OF THE TRAVELERS PROPERTY CASUALTY COMPANIES ONE TOWER SQUARE, HARTFORD, CT 06183 DAVID BUMPASS 4915 E CRESTWOOD DR LITTLE ROCK, AR 72207-5407 0180056376 612694758 653 1 09/16/2023 09/16/2024 415 N MONROE ST Coverage A - Dwelling Coverage B - Other Structures Coverage C – Household Furnishings Coverage D - Loss of Use Coverage E – Premises Liability (each occurrence) Coverage F - Medical Payments to Others(each person) Property Coverage Deductible (All Perils) TOTAL PREMIUM $1,344.00 AMERIHOME MORTGAGE COMPANY LLC ISAOA ATIMA PO BOX 202028 FLORENCE, SC 29502 X 0180056376 MARY K RUDE LITTLE ROCK, AR 72205-3739 $ $ $ $ $ $ $ Make checks payable to: Travelers Indemnity and affiliates Mail payments to: SEE ADDITIONAL REMARKS SCHEDULE FOR MORE INFORMATION (ACORD 101) Policy Type – Landlord Dwelling Optional Coverages Optional Coverages Endorsement Limit Special Coverage HQ-003 CW (05-18) Water Back Up and Sump Discharge or Overflow Coverage HQ-208 CW (08-20)$5,000 Additional Replacement Cost Protection Coverage HQ-420 CW (11-18)$64,500 25% of Coverage A - Dwelling Limit Roof Systems Payment Schedule Windstorm or Hail Losses HQ-646 CW (05-17) Roof Material Type: Age of Roof: ARCH 18 Home-Sharing Host Activities Coverage Landlord HQ-858 CW (11-18) *Note: The additional cost or premium reduction for any optional coverage or package shown as “Included” is contained in the Total Policy Premium Amount. AGENCY NAMED INSURED POLICY NUMBER CARRIER NAIC CODE EFFECTIVE DATE: AGENCY CUSTOMER ID: LOC #: THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER:FORM TITLE: ADDITIONAL REMARKS ACORD 101 (2008/01)© 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Page ofADDITIONAL REMARKS SCHEDULE 1 1 MCGRIFF INS SERVICES LLC 612694758 653 1 TRAVELERS PERSONAL INSURANCE COMPANY 38130 DAVID BUMPASS 09/16/2023 ACORD 27 EVIDENCE OF PROPERTY INSURANCE MARY K RUDE 4915 E CRESTWOOD DR LITTLE ROCK, AR 72207-5407