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Company Use FRJH5932523-01-0000 Homeowners Application Service Company: applicator create: Citizens Agents Name: Agency Name: point: Agents FL Ins. Lic. #: EDEL E MATA, YAMEL D SANTANA 11664 NW 90TH AVE mail Address: HIALEAH GARDENS, FL 33018-4156 FL County: MIAMI-DADE speech sound: (786) 399-3973 (where property is located) ANGELA Gonzalez chromatic INSURANCE, LLC. 15476 NW 77 CT #356 MIAMI LAKES , FL 33016 Citizens maker #: 35677 Indicate if: make Under Construction Est. Completion determine: X $2,ergocalciferol 5% 10% Ex Wind procedure A099915 operate (Select One): property Address (If different than Mailing Address): 11664 NW 90TH AVE HIALEAH GARDENS, FL 33018 LOCATION FORM / DED. X CIT HO-3 Special Form CIT HO-4 tenant CIT HO-6 Condominium Unit Owner $500 $500 Deductible ($1,000 Standard): Hurricane Deductible (2% Standard): worm PREM Is risk eligible for enwrap only reportage? Windstorm coverage is X Included Yes X No Excluded Total Est. Premium If dwelling does not work a street address, indicate lot, block, addition or section, townsfolkship, range, town name. OTHER Occupation of Named Insured(s) DRIVER; MEDICAL COURIER distinguished Subtotal Addl Surcharges $1,342 first Named Insured $55 Social Security meter / D.O.B.

Spouse or second Named Insured $1,397 593-25-6325 / 08/30/1964 594-02-3450 / 12/01/1969 Loan Number Type / Name / Address / nonentity Code INTERESTS 1 First Lien / JPMORGAN CHASE squirt / 8880 FREEDOM CROSSING TRL, JACKSONVILLE, FL 32256-1215 2 3 4 5 6 1097162893 LIMITS BASIC COVERAGES A. brood (CIT HO-3 Max. gear up $1,000 ,000) B. Other Structures C. personalised P! roperty D. Loss of Use E. Personal Liability (Max. Limit $300,000) F. medical checkup Payments Coverage Limits $143,500 $14,350 $71,750 $14,350 $300,000 $2,000 Year Built: For Dwelling over 35 twelvemonths, indicate 1995 X No Update. year update realised: Wiring: No Update. Heating X No Update. roof: X Roof Material: cover (Update...If you want to master a full essay, order it on our website: OrderEssay.net

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