State Farm Florida Insurance Company

A Stock Company With Home Offices in Winter Haven, Florida

Po Box 88049
Atlanta GA 30356-9901 ____

____ AT3 H-19-7400-FA6F F H 4

MORA, ENRIQUE
3201 BALANCE DUE NOTICE
1100 BRICKELL BAY DR APT 41M
MIAMI FL 33131-3558 AMOUNT DUE: SEE NOTE
____ ____
____ Payment is due by SEE NOTE
____ ____
____
Policy Number: 80-CH-U730-2
____ ____
Policy Period: 12 Months
Effective Dates: FEB 15 2020 to FEB 15 2021

Your State Farm Agent

Location of Residence Premises ERIKAMARIE GIL INS AGENCY INC
1100 BRICKELL BAY DR APT 41M 33 SW 2ND AVE STE 101
MIAMI FL 33131-3558 MIAMI FL 33130-1583

Phone: (305) 350-2020

IMPORTANT MESSAGES

000453 H FEB 26 2020 3201 19

Full payment by Date Due continues this policy to FEB 15 2021
Note: Do not pay. Payment is being made through State Farm Payment Plan. Account # 1480054619

60
Thanks for letting us serve you!
When you provide a check as payment, you authorize us either to use the information from your check to make a one-time
electronic fund transfer from your account or to process the payment as a check transaction. When we use information
from your check to make an electronic funds transfer, funds may be withdrawn from your account as soon as the same day
we receive your payment, and you will not receive your check back from your financial institution.

Prepared: FEB 26 2020 Page 1 of 1

Please fold and tear here 04-05-2018 (o1F1082E)

Power To Pay Online Mobile Call Mail Visit your

statefarm.com/pay Use the Automated Line: 800-440-0998 Send us a State Farm
Your Way State Farm mobile app Your agent: (305) 350-2020 check agent
Key code: 68 2358 9385 HO - RENTERS

Insured Name: MORA, ENRIQUE 1909005015

Policy Number: 80-CH-U730-2
AMOUNT DUE: SEE NOTE
Please pay by SEE NOTE
Make payment to State Farm
For Office Use Only FIRE BAL DUE 0501
1S,2W,K2,8Y
 State Farm Florida Insurance Company
A Stock Company With Home Offices in Winter Haven, Florida
Po Box 88049
Atlanta GA 30356-9901 ____

____ AT3 H-19-7400-FA6F F H 4

MORA, ENRIQUE
3201 DECLARATIONS
1100 BRICKELL BAY DR APT 41M
MIAMI FL 33131-3558
____ ____
____ AMOUNT DUE: enoN
____ ____
Payment is due by BILLED THRU SFPP ____
____ ____
Policy Number: 80-CH-U730-2

Policy Period: 12 Months

Effective Dates: FEB 15 2020 to FEB 15 2021
The policy period begins and ends at 12:01 am standard
time at the residence premises.

RENTERS POLICY Your State Farm Agent

ERIKAMARIE GIL INS AGENCY INC
Location of Residence Premises 33 SW 2ND AVE STE 101
1100 BRICKELL BAY DR APT 41M MIAMI FL 33130-1583
MIAMI FL 33131-3558

3201 19
Phone: (305) 350-2020
Year Built: 2018

Automatic Renewal

000453 H
If the POLICY PERIOD is shown as 12 MONTHS, this policy will be renewed automatically subject to the premiums, rules,
and forms in effect for each succeeding policy period. If this policy is terminated, we will give you and the Mortgagee/Lien-

60
holder written notice in compliance with the policy provisions or as required by law.

IMPORTANT MESSAGES
Zone: 06
For questions, problems, or to obtain information about coverage call: 305-350-2020
PREMIUM
Annual Premium $ 00.782
Covered Loss Due to
Hurricane Event 00.05 )dedulcnI(
Other Covered Losses 00.732 )dedulcnI(
FL EMPA ASSESSMENT 00.2 $
Your premium has already been adjusted by the following:
Sprinkler
Bldg Code Rating
Wind Mitigation

Prepared FEB 26 2020 Page 1 of 4

 NAMED INSURED MORTGAGEE AND ADDITIONAL INTERESTS
MORA, ENRIQUE
PANORAMA Loan Number:
PO BOX 3885 N/A
ALBANY NY 12203-0885

____

SECTION I - PROPERTY COVERAGES AND LIMITS

Coverage Limit of Liability
B Personal Property $ 000,01
C Loss of Use $ 000,4
Fungus (including Mold) Limited Coverage $ 000,01
Additional Coverages
Arson Reward 000,1$
Credit Card, Bank Fund Transfer Card, Forgery, and Counterfeit Money 000,1$
Debris Removal elbaliava %5 lanoitiddA
Fuel Oil Release 000,01$
Locks and Remote Devices 000,1$
Trees, Shrubs, and Landscaping meti rep 057$/tnuoma B egarevoC fo %01
SECTION II - LIABILITY COVERAGES AND LIMITS
Coverage Limit of Liability

FEB 26 2020
L Personal Liability (Each Occurrence) $ 000,001
Damage to the Property of Others $ 000,1
M Medical Payments to Others (Each Person) $ 000,1
INFLATION
Inflation Coverage Index: 258.0
DEDUCTIBLES
o1F1081A

Section I Deductible Deductible Amount

All Losses $
Hurricane $
000,1
000,1
LOSS SETTLEMENT PROVISIONS
B1 Limited Replacement Cost - Coverage B
 80-CH-U730-2
FORMS, OPTIONS, AND ENDORSEMENTS
H4-2159 Renters Policy
HO-2568 FL Cat Grnd Cover Collapse Cov
HO-2446 Back-Up Of Sewer Or Drain -
30% of Coverage B/$ 3,000
HO-2571 Hurricane Deductible
HO-2570 Fungus (Incl Mold) Limited Cov
ADDITIONAL MESSAGES
Your building code effectiveness grading schedule adjustment can range from a surcharge of 1% to a credit of 8%.
Your Building Code Effectiveness Grading Schedule Adjustment: $11.00 CR
Hurricane Deductible Notice
Hurricane Deductibles may be per calendar year. There is also a possibility that the deductible applied at the time
of hurricane loss may be different than the amount shown. Refer to the applicable hurricane deductible and/or
hurricane coverage endorsement attached to this policy. Please contact your State Farm agent if you have any
questions.
State Farm® works hard to offer you the best combination of price, service, and protection. The amount you pay for
homeowners insurance is determined by many factors such as the coverages you have, the type of construction, the
likelihood of future claims, and information from consumers reports.

Your premium was influenced by information from consumer reports:

Time since the most recent account delinquency; Presence of an adverse item in the last 60 months; Number of revolving
accounts opened in the last 24 months; Number of Consumer Initiated Credit Card Inquiries in 24 Months / Percent of
Accounts with Balance.
You have the right to request, no more than once annually, that your policy be re-rated using a current credit-based
insurance score. Re-rating could result in a lower rate, no change in rate, or a higher rate.
Please refer to the enclosed insert for additional details.
o1F1083A

Other limits and exclusions may apply - refer to your policy

Prepared FEB 26 2020 Page 3 of 4

o1F1081A

FEB 26 2020
____
 80-CH-U730-2 003120

____
____ ____
 80-CH-U730-2 003121

____
____ ____
 80-CH-U730-2 003122

____
____ ____

(CONTINUED)
 80-CH-U730-2 003123

____
____ ____

(CONTINUED)
 80-CH-U730-2 003124

____
____ ____

(CONTINUED)
(CONTINUED)
 80-CH-U730-2 003125

____ ____