Progressive Home Insurance

AMERICAN STRATEGIC INSURANCE CORP

1 ASIWay St. Petersburg, FL 33702

Homeowners Declaration Page

PROGREIIIVE? HOME

Named Insured: KEITH A LEGGETT AND KRISTAN M LEGGETT 3634 VILLAMORE LN ODESSA, FL 33556

Total Policy Premium: Policy Number:

Agent: Westwood Ins Agency Inc 8407 Fallbrook Ave #200 West Hills, CA 91304

$1,195 FLA390680

Effective Date of This Transaction:

12/7/2020

Activity of This Transaction: Residence Premises: 3634 VILLAMORE LN ODESSA, FL 33556-4193

Renewal

Agent Code: For Policy Service, Call:

411187 (800)676-5066

Policy Period:

From: 12/07/2020 To: 12/07/2021

(At 12:01 AM Standard Time at the residence premises)

Plan Type: NH3

Coverage at the residence premises is provided only where a limit of liability is shown or a premium is stated.

Coverages and Limits of Liability

Limit

Premium

SECTION I: SECTION II:

A. Dwelling Coverage B. Other Structures C. Personal Property D. Loss of Use E. Personal Liability - Each Occurrence F. Medical Payments to Others - Each Person

$361,000 $7,220 $180,500 $36,100 $300,000 $1,000

5351.08 Included Included Included

15.00 Included

OTHER COVERAGES AND ENDORSEMENTS: (Printed on the following page)

Deductibles:

HURRICANE: ALL OTHER COVERED PERILS:

2%- $7220 $1000

Mortgagee:

1st Mortgagee:

WELLS FARGO BANK NA #936 ISAOA

PO BOX 100515

FLORENCE, SC 29502-0515

Loan #0593152598

Escrow: Yes

2nd Mortgagee:

Countersigned by Authorized Representative

St. Petersburg, FL

Date: 10/07/2020

ASI HO FL DEC 10 18

The ASI Group is an affiliate of The Progressive Corporation

Page 1 of2

Named lnsured(s):

KEITH A LEGGETT AND KRISTAN M LEGGETT

Policy Number:

FLA390680

Other Coverages And Endorsements: Homeowners Policy Outline Homeowners 3 - Special Form Special Provisions for Florida Home Day Care Explanation Catastrophic Ground Cover Collapse Coverage - Florida Hurricane Deductible Endorsement Assignment Agreement Endorsement - Florida Ordinance or Law Coverage Notification Form - Florida Windstorm Protective Devices Burglar Protection Increased Repl Cost on Dwelling E-Policy (Paperless) Windstorm Loss Reduction NHR Deductible HUR Deductible Animal Liability Replacement Cost on Contents Limited Fungi,Mold,Wet/Dry Rot PC I Construction Factor Age of Dwelling Number of Stories Age of Roof BCEG

Form Number ASI HO 09 OTL 01 10 HO 00 03 04 91 ASI HO 09 SP 12 13 HO 04 96 04 91 ASI HO 09 CG 08 12 ASI HO 09 HD 05 05 ASI HO FL AAE 01 20 ASI HO FL OLR 08 16 HO 04 2110 94 ASI HO 09 PA 06 07 ASI HO FL IRC 08 16

ASI HO FL AL 01 18 HO23 86 0106 ASI HO FL LF 0118

Fees and Assessments: Managing General Agent Fee Emergency Management Preparedness Assistance Fee

Scheduled Items: Category

Description of Property

Limit

Premium

72200

1000 7220 50000 $10,000

-25.75 100.73

-4.89 -1825.90

-37.15 -99.11 25.00 302.20 Included -46.17 -2050.55 60.45 -446.30 -151.09

25.00 2.00

Value Premium

The Hurricane Coverage portion of your Total Premium is: The Non-Hurricane Coverage portion of your Total Premium is:

Additional Insured:

Additional Interest:

Rating Information: Construction Type: Type of Residence: Year Built:

Notes:

Pagel of2

Frame Single Family 2018

Interest:

Total Square Feet: ASI Territory: County:

The ASI Group is an affiliate of The Progressive Corporation

$607 $588

2,585 471A HILLSBOROUGH

ASI HO FL DEC 10 18

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