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Hoelsher, Jenova ConnerUniversal Property & Casualty Insurance Company, Homeowners AL A Stock CompanyUNIV Declaration Effective PRO TY c/o Evolution Risk Advisors, Inc. 1110 W. Commercial Blvd 06/12/2024 r Fort Lauderdale, FL 33309 Renewal Policy g 6 THIS IS NOT A BILL For Policy or Claims Questions Contact Your Agent Listed Below Policy Number FROM Policy Period TO INSURED BILLED Agent Co 1501-1201-6377 06/12/2024 06/12/2025 12:01 AM Standard Time BQ77 Named Insured and Address Agent Name and Address Jenova Hoelscher Berger Insurance Associates, LLC 1815 SW 5th Avenue 321 N Parrott Ave Okeechobee, FL 34974 Okeechobee, FL 34972 (863) 467-1090 (863) 763-6411 Insured Location 1815 SW 5TH AVE OKEECHOBEE, FL 34974 OKEECHOBEE COUNTY Premium Summary Basic Coverages Attached Endorsements Total Policy Premium Premium Premium Assessments / Surcharges MGA Fees/Policy Fees (Including Assessments & Surcharges) $14,621.00 ($11,575.00) $4,478.00 $102.24 $7,626.24 Rating Information Townhouse/ Number of Protection Form Construction Year Rowhouse Families Occupied Class Territory BCEG H03 Masonry 1980 N 1 Y 3 555 99 Dwelling Personal Property Protective Device Credits: County Replacement Cost Replacement Cost Burglar Fire Sprinkler Okeechobee Y Y Y N N We will provide the insurance described in this policy in return for the premium and compliance with all applicable provisions of this policy. For renewals: If we elect to continue this insurance, we will renew this policy if you pay the required renewal premium for each successive policy period subject to our premiums, rules and forms then in effect. You must pay us prior to the end of the current policy period or else this policy will expire. Insurance is provided only with respect to the following coverages for which a limit of liability is specified, subject to all the conditions of this policy. COVERAGES - SECTION I LIMITS PREMIUMS COVERAGES - SECTION II LIMITS PREMIUMS Coverage A - Dwelling $424,705 $14,621.00 Coverage E - Personal Liability $300,000 $18.00 Coverage B - Other Structure $42,483 Coverage F - Medical Payments $3,000 $5.00 Coverage C - Personal Property $212,353 Coverage D - Loss of Use $84,941 NOTE: The portion of your premium for hurricane coverage is: $4,634.17 The portion of your premium for all other coverages is: $2,992.07 Section I Coverages Subject to a 2.0% of Coverage A - $8,494 Hurricane Deductible Per Calendar Year. Section I Coverages Subject to $1,000 All Other Perils (Non -Hurricane, Non -Sinkhole) Deductible Per Loss. The Ordinance or Law Coverage amount is 25% of Coverage A - $106,176 THIS POLICY CONTAINS A SEPARATE DEDUCTIBLE FOR HURRICANE LOSSES WHICH MAY RESULT IN HIGH OUT- OF-POCKET EXPENSES TO YOU. Flood coverage is not provided by Universal Property & Casualty Insurance Company and is not part of this policy. Berger Insurance Associates, LLC -�� / Z�Z6 Countersignature Date Chief Executive Officer UPCIC HO DEC 15 03 23 Printed Date: 4/23/2024 2:52:17 AM 1 of 3 0 N Universal Property & Casualty Insurance Company, UNIVERSAL A Stock Company c/o Evolution Risk Advisors, Inc. Declaration Effective PROPERTY 1110 W. Commercial Blvd 06/12/20244 "A,1-1 Fort Lauderdale, FL 33309 Renewal Policy THIS IS NOT A BILL Policy Number FROM Policy Period TO INSURED BILLED Agent Code 1501-1201-6377 06/12/2024 06/12/2025 12:01 AM Standard Time BQ77 PLEASE VISIT UNIVERSALPROPERTY.COM TO VIEW YOUR APPLICABLE POLICY FORMS AND ENDORSEMENTS. LOG IN AND CLICK MY POLICIES/POLICY DETAILS OR TYPE THIS URL INTO YOUR INTERNET BROWSER: o HTTPS:HUNIVERSALPROPERTY.COM/ACCOUNT/LOGIN. YOU HAVE THE RIGHT TO � REQUEST AND OBTAIN WITHOUT CHARGE A PAPER OR ELECTRONIC COPY OF YOUR POLICY AND ENDORSEMENTS BY CONTACTING YOUR AGENT OR CALLING CUSTOMER SERVICE AT 1-800-425-91131. LAW AND ORDINANCE: LAW AND ORDINANCE COVERAGE IS AN IMPORTANT COVERAGE THAT YOU MAY WISH TO PURCHASE. PLEASE DISCUSS WITH YOUR INSURANCE AGENT. FLOOD INSURANCE: YOU SHOULD CONSIDER THE PURCHASE OF FLOOD INSURANCE. YOUR HOMEOWNER'S INSURANCE POLICY DOES NOT INCLUDE COVERAGE FOR DAMAGE RESULTING FROM FLOOD EVEN IF HURRICANE WINDS AND RAIN CAUSED THE FLOOD TO OCCUR. WITHOUT SEPARATE FLOOD INSURANCE COVERAGE, YOUR UNCOVERED LOSSES CAUSED BY FLOOD ARE NOT COVERED. PLEASE DISCUSS THE NEED TO PURCHASE SEPARATE FLOOD INSURANCE COVERAGE WITH YOUR INSURANCE AGENT. COINSURANCE CONTRACT: THIS POLICY CONTAINS A CO - PAY PROVISION THAT MAY RESULT IN HIGH OUT-OF- POCKET EXPENSES TO YOU. IMPORTANT: This replaces all previously issued policy declarations, if any and is subject to all forms and endorsements attached to this policy. UPCIC HO DEC 15 03 23 Printed Date: 4/23/2024 2:52:17 AM 3 of 3 Universal Property & Casualty Insurance Company, Homeowners A Stock CompanyUNIVERSAL c/o Evolution Risk Advisors, Inc. Declaration Effective PROPERTY 1110 W. Commercial Blvd 5/3/2024 Fort Lauderdale, FL 33309 AMENDED: Insured Change THIS IS NOT A BILL For Policy or Claims Questions Contact Your Agent Listed Below Policy Number FROM Policy Period TO INSURED BILLED Agent Code 1501-1201-6377 06/12/2023 06/12/2024 12:01 AM Standard Time BQ77 Named Insured and Address Agent Name and Address Jenova Hoelscher Berger Insurance Associates, LLC 1815 SW 5th Ave 321 N Parrott Ave Okeechobee, FL 34974 Okeechobee, FL 34972 (813)466-2217 (863)763-6411 Insured Location 1815 SW 5TH AVE OKEECHOBEE, FL 34974 OKEECHOBEE COUNTY Premium Summary Basic Coverages Attached Endorsements Total Policy Premium Premium Premium Assessments / Surcharges MGA Fees/Policy Fees (Including Assessments & Surcharges) $13,172.00 ($10,309.00) $4,034.00 $164.94 $7,061.94 Rating Information Townhouse/ Number of Protection Form Construction Year Rowhouse Families Occupied Class Territory BCEG H03 Masonry 1980 N 1 Y 3 555 99 Dwelling Personal Property Protective Device Credits: County Replacement Cost Replacement Cost Burglar Fire Sprinkler Okeechobee Y Y Y N N We will provide the insurance described in this policy in return for the premium and compliance with all -applicable provisions of this policy. For renewals: If we elect to continue this insurance, we will renew this policy if you pay the required renewal premium for each successive policy period subject to our premiums, rules and forms then in effect. You must pay us prior to the end of the current policy period or else this policy will expire. Insurance is provided only with respect to the following coverages for which a limit of liability is specified, subject to all the conditions of this policy. COVERAGES - SECTION I LIMITS PREMIUMS COVERAGES - SECTION II LIMITS PREMIU g 10 1 Coverage A -Dwelling $424,705 $13,172.00 Coverage E Personal Liability $300,000CMAY Coverage B - Other Structure $42,482 Coverage F - Medical Payments $3,000 Coverage C - Personal Property $212,353 Coverage D - Loss of Use $84,941 NOTE: The portion of your premium for hurricane coverage is: $4,293.32 The portion of your premium for all other coverages is: $2,768.62 Section I Coverages Subject to a 2.0% of Coverage A - $8,494 Hurricane Deductible PeYear. Section I Coverages Subject to $1,000 All Other Perils (Non -Hurricane, Non -Sinkhole) Deductible Per Loss. The Ordinance or Law Coverage amount is 25% of Coverage A - $106,176 THIS POLICY CONTAINS A SEPARATE DEDUCTIBLE FOR HURRICANE LOSSES WHICH MAY RESULT IN HIGH OUT- OF-POCKET EXPENSES TO YOU. Flood coverage is not provided by Universal Property & Casualty Insurance Company and is not part of this policy. Berger Insurance Associates, LLC 50� 4�z za6 Countersignature Date Chief Executive Officer UPCIC HO DEC 15 03 23 Printed Date: 5/4/2024 3:54:13 AM 1 of 3 Cl 0 0 Universal Property & Casualty Insurance Company, UNIVERSAL A Stock Company Declaration Effective PROPERTY c/o Evolution Risk Advisors, Inc. 1110 W. Commercial Blvd 5/3/20244 11"11 °'„""` Fort Lauderdale, FL 33309 AMENDED: Insured Change THIS IS NOT A BILL Policy Number FROM Policy Period TO INSURED BILLED Agent Code 1501-1201-6377 06/12/2023 06/12/2024 12:01 AM Standard Time BQ77 Mortgagee/Additional Interest 01 City of Okeechobee 55 SE 3rd Ave Okeechobee, FL 34974 Additional Insured NUMBER EDITION UPCIC H03 15 10 21 UPCIC 905 15 03 18 UPCIC 801 15 12 17 UPCIC 406 15 05 18 UPCIC 702 15 05 18 UPCIC 802 15 12 17 UPCIC 601 15 12 17 UPCIC 101 15 04 22 UPCIC 201 15 05 21 Additional Interest Mortgagee/Additional Interest 02 Policy Forms & Endorsements Applicable to This Policy DESCRIPTION Homeowners 3 Special Form Outline of Your Homeowner Policy Windstorm Protective Devices Personal Property Replacement Cost Additional Insured - Residence Premises Premises Alarm or Fire Protection System No Coverage for Home Day Care Business Additional Policy Provisions Calendar Year Hurricane Deductible With Supplemental Reporting Requirement - Florida Year Built Surcharge Personal Liability Increase Endorsement Medical Payment Increase Endorsement Emergency Management Preparedness Assistance Trust Fund MGA Fee 2022 Florida Insurance Guaranty Association Recoupment 2022B Florida Insurance Guaranty Association Recoupment Mortgagee/Additional Interest 03 LIMITS PREMIUMS $13,172.00 ($12,178.00) $1,983.00 $300,000 $3,000 ($137.00) $4,034.00 $18.00 $5.00 $2.00 $25.00 $89.66 $48.28 YOUR POLICY PROVIDES COVERAGE FOR A CATASTROPHIC GROUND COVER COLLAPSE THAT RESULTS IN THE PROPERTY BEING CONDEMNED AND UNINHABITABLE. OTHERWISE, YOUR POLICY DOES NOT PROVIDE COVERAGE FOR SINKHOLE LOSSES. YOU MAY PURCHASE ADDITIONAL COVERAGE FOR SINKHOLE LOSSES FOR AN ADDITIONAL PREMIUM. UPCIC HO DEC 15 03 23 Printed Date: 5/4/2024 3:54:13 AM 2 of 3 Universal Property & Casualty Insurance Company, A Stock Company UNIVERSAL c/o Evolution Risk Advisors, Inc. Declaration EffectivePROPERTY ft 1110 W. Commercial Blvd IGSGLT'P'sl'RA]CF.004P.i\l' 5/3/2024 Fort Lauderdale, FL 33309 AMENDED: Insured Change THIS IS NOT A BILL Policy Number FROM Policy Period TO INSURED BILLED Agent Code 1501-1201-6377 06/12/2023 06/12/2024 12:01 ANI Standard Time B077 PLEASE VISIT UNIVERSALPROPERTY.COM TO VIEW YOUR APPLICABLE POLICY FORMS AND ENDORSEMENTS. LOG IN AND CLICK MY POLICIES/POLICY DETAILS OR TYPE THIS URL INTO YOUR INTERNET BROWSER: HTTPS://UNIVERSALPROPERTY.COM/ACCOUNT/LOGIN. YOU HAVE THE RIGHT TO REQUEST AND OBTAIN WITHOUT CHARGE A PAPER OR ELECTRONIC COPY OF YOUR POLICY AND ENDORSEMENTS BY CONTACTING YOUR AGENT OR CALLING CUSTOMER SERVICE AT 1-800-425-9113. LAW AND ORDINANCE: LAW AND ORDINANCE COVERAGE IS AN IMPORTANT COVERAGE THAT YOU MAY WISH TO PURCHASE. PLEASE DISCUSS WITH YOUR INSURANCE AGENT. FLOOD INSURANCE: YOU SHOULD CONSIDER THE PURCHASE OF FLOOD INSURANCE. YOUR HOMEOWNER'S INSURANCE POLICY DOES NOT INCLUDE COVERAGE FOR DAMAGE RESULTING FROM FLOOD EVIEN IF HURRICANE WINDS AND RAIN CAUSED THE FLOOD TO OCCUR. WITHOUT SEPARATE FLOOD INSURANCE COVERAGE, YOUR UNCOVERED LOSSES CAUSED BY FLOOD ARE NOT COVERED. PLEASE DISCUSS THE NEED TO PURCHASE SEPARATE FLOOD INSURANCE COVERAGE WITH YOUR INSURANCE AGENT. COINSURANCE CONTRACT: THIS POLICY CONTAINS A CO - PAY PROVISION THAT MAY RESULT IN HIGH OUT-OF- POCKET EXPENSES TO YOU. IMPORTANT: This replaces all previously issued policy declarations, if any and is subject to all forms and endorsements attached to this policy. UPCIC HO DEC 15 03 23 Printed Date: 5/4/2024 3:54:13 AM 3 of 3 A. Universal Property & Casualty Insurance Company, A Stock CompanyUNIV Homeowners RED AL c/o Evolution Risk Advisors, Inc. Declaration Effective PRO T 1110 W. Commercial Blvd 06/12/2022 &CefiUnLTV I\ %RAA' GO?1 YA�y Fort Lauderdale, FL 33309 Renewal Policy THIS IS NOT A BILL For Policy or Claims Questions Contact Your Agent Listed Below Policy Number FROM Policy Period TO INSURED BILLED Agent Code 1501-1201-6377 06/12/2022 06/12/2023 12:01 AM Standard Time BQ77 Named Insured and Address Agent Name and Address Jenova Hoelscher Berger Insurance Associates, LLC 1815 SW 5th Avenue 120 Sw 5th Ave Okeechobee, FL 34974 Okeechobee, FL 34974 (863)467-1090 (863)763-6411 Insured Location 1815 SW 5TH AVE OKEECHOBEE, F1.. 34974 OKEECHOBEE COUNTY Premium Summary Basic Coverages Attached Endorsements Total Policy Premium Premium Premium Assessments / Surcharges MGA Fees/Policy Fees (Including Assessments & Surcharges) $8,993.00 ($6,510.00) $2,637.00 $62.84 $5,182.84 Rating Information Townhouse/ Number of Protection Form Construction Year Rowhouse Families Occupied Class Territory BCEG H03 Masonry 1980 N 1 Y 3 555 99 Dwelling Personal Property Protective Device Credits: County Replacement Cost Replacement Cost Burglar Fire Sprinkler Okeechobee Y Y Y N N We will provide the insurance described in this policy in return for the premium and compliance with all applicable provisions of this policy. For renewals: It we elect to continue this insurance, we will renew this policy if you pay the required renewal premium for each successive policy period subject to our premiums, rules and forms then in effect You must pay us prior to the end of the current policy period or else this policy will expire. Insurance is provided only with respect to the following coverages for which a limit of liability is specified, subject to all the conditions of this policy. COVERAGES - SECTION I LIMITS PREMIUMS COVERAGES - SECTION II LIMITS PREMIUMS Coverage A - Dwelling $391,072 $8,993.00 Coverage E - Personal Liability $300,000 $18.00 Coverage B - Other Structure $39,118 Coverage F - Medical Payments $3,000 $5.00 Coverage C - Personal Property $195,536 Coverage D - Loss of Use $78,215 NOTE: The portion of your premium for hurricane coverage is: $2,740.31 The portion of your premium for all other coverages is: $2,442.53 Section I Coverages Subject to a 2.0% of Coverage A - $7,821 Hurricane Deductible Per Calendar Year. Section I Coverages Subject to $1,000 All Other Perils (Non -Hurricane, Non -Sinkhole) Deductible Per Loss. The Ordinance or Law Coverage amount is 25% of Coverage A - $97,768 THIS POLICY CONTAINS A SEPARATE DEDUCTIBLE FOR HURRICANE LOSSES WHICH MAY RESULT IN HIGH OUT- OF-POCKET EXPENSES TO YOU. Flood coverage is not provided by Universal Property & Casualty Insurance Company and is not part of this policy. Berger Insurance Associates, LLC Countersignature Date Chief Executive Officer UPCIC HO DEC 15 02 20 Printed Date: 4/23/2022 3:07:43 AM 1 of 3 0 W G) Universal Property & Casualty Insurance Company, UNIVERSAL A Stock Company Mortgagee/Additional Interest 01 Mortgagee/Additional Interest 02 Mortgagee/Additional Interest 03 City of Okeechobee Declaration Effective 04PROPERT Y c/o Evolution Risk Advisors, Inc. 55 SE 3rd Ave �..,�: 06/12/2022 .,>, 1110 W. Commercial Blvd Fort Lauderdale, FL 33309 Renewal Policy THIS IS NOT A BILL Policy Number FROM Policy Period TO INSURED BILLED Agent Code 1501-1201-6377 06/12/2022 06/12/2023 12:01 AM Standard Time BQ77 YOUR POLICY PROVIDES COVERAGE FOR A CATASTROPHIC GROUND COVER COLLAPSE THAT RESULTS IN THE PROPERTY BEING CONDEMNED AND UNINHABITABLE. OTHERWISE, YOUR POLICY DOES NOT PROVIIDE COVERAGE FOR SINKHOLE LOSSES. YOU MAY PURCHASE ADDITIONAL COVERAGE FOR SINKHOLE LOSSES FOR AN ADDITIONAL PREMIUM. UPCIC HO DEC 15 02 20 Printed Date: 4/23/2022 3:07:43 AM 2 of 3 Additional Interest Mortgagee/Additional Interest 01 Mortgagee/Additional Interest 02 Mortgagee/Additional Interest 03 City of Okeechobee 55 SE 3rd Ave Okeechobee, FL 34974 Additional Insured Policy Forms & Endorsements Applicable to This Policy NUMBER EDITION DESCRIPTION LIMITS PREMIUMS UPCIC H03 15 10 21 Homeowners 3 Special Form $8,993.00 UPCIC 905 15 03 18 Outline of Your Homeowner Policy UPCIC 801 15 1217 Windstorm Protective Devices ($7,764.00) UPCIC 406 15 05 18 Personal Property Replacement Cost $1,356.00 UPCIC 702 15 05 18 Additional Insured - Residence Premises UPCIC 802 15 12 17 Premises Alarm or Fire Protection System ($125.00) UPCIC 601 15,1217 No Coverage for Home Day Care Business UPCIC 201 15 05 21 Calendar Year Hurricane Deductible With Supplemental Reporting Requirement - Florida Year Built Surcharge $2,637.00 Personal Liability Increase Endorsement $300,000 $18.00 Medical Payment Increase Endorsement $3,000 $5.00 Emergency Management Preparedness Assistance Trust Fund _ $2.00 MGA Fee $25.00 2021 Florida Insurance Guaranty Association Recoupment $35.84 YOUR POLICY PROVIDES COVERAGE FOR A CATASTROPHIC GROUND COVER COLLAPSE THAT RESULTS IN THE PROPERTY BEING CONDEMNED AND UNINHABITABLE. OTHERWISE, YOUR POLICY DOES NOT PROVIIDE COVERAGE FOR SINKHOLE LOSSES. YOU MAY PURCHASE ADDITIONAL COVERAGE FOR SINKHOLE LOSSES FOR AN ADDITIONAL PREMIUM. UPCIC HO DEC 15 02 20 Printed Date: 4/23/2022 3:07:43 AM 2 of 3 Universal Property & Casualty Insurance Company, UNIVERSAL A Stock Company c/o Evolution Risk Advisors, Inc. Declaration Effective PROPERTY 1110 W. Commercial Blvd 06/12/2022 Fort Lauderdale, FL 33309 Renewal Policy THIS IS NOT A BILL Policy Number FROM Policy Period TO INSURED BILLED Agent Code 1501-120'1-6377 I 06/12/2022 06/12/2023 I 12:01 AM Standard Time BQ77 PLEASE VISIT UNIVERSALPROPERTY.COM TO VIEW YOUR APPLICABLE POLICY FORMS AND ENDORSEMENTS. LOG IN AND CLICK MY POLICIES/POLICY DETAILS OR TYPE THIS URL INTO YOUR INTERNET BROWSER: HTTPS://UNIVERSALPROPERTY.COM/ACCOUNT/LOGIN. YOU HAVE THE RIGHT TO REQUEST AND OBTAIN WITHOUT CHARGE A PAPER OR ELECTRONIC COPY OF YOUR POLICY AND ENDORSEMENTS BY CONTACTING YOUR AGENT OR CALLING CUSTOMER SERVICE AT 1-800-425-9113. LAW AND ORDINANCE: LAW AND ORDINANCE COVERAGE IS AN IMPORTANT COVERAGE THAT YOU MAY WISH TO PURCHASE. PLEASE DISCUSS WITH YOUR INSURANCE AGENT. FLOOD INSURANCE: YOU MAY ALSO NEED TO CONSIDER THE PURCHASE OF FLOOD INSURANCE. YOUR HOMEOWNER'S INSURANCE POLICY DOES NOT INCLUDE COVERAGE FOR DAMAGE RESULTING FROM FLOOD EVEN IF HURRICANE WINDS AND RAIN CAUSED THE FLOOD TO OCCUR. WITHOUT SEPARATE FLOOD INSURANCE COVERAGE, YOU MAY HAVE UNCOVERED LOSSES CAUSED BY FLOOD. PLEASE DISCUSS THE NEED TO PURCHASE SEPARATE FLOOD INSURANCE COVERAGE WITH YOUR INSURANCE AGENT. COINSURANCE CONTRACT: THIS POLICY CONTAINS A CO - PAY PROVISION THAT MAY RESULT IN HIGH OUT-OF- POCKET EXPENSES TO YOU. IMPORTANT: This replaces all previously issued policy declarations, if any and is subject to all forms and endorsements attached to this policy. UPCIC HO DEC 15 02 20 Printed Date: 4/23/2022 3:07:43 AM 3 of 3 Universal Property & Casualty Insurance Company, Homeowners UNIVERSAL A Stock Company c/o Evolution Risk Advisors, Inc. Declaration EffectivePROPERTY 1110 W. Commercial Blvd 6/21/2021 Fort Lauderdale, FL 33309 AMENDED: Insured Change THIS IS NOT A BILL For Policy or Claims Questions Contact Your Agent Listed Below Policy Number FROM Policy Period TO INSURED BILLED Agent Code 1501-1201-6377 06/12/2021 06/12/2022 12:01 AM Standard Time BQ77 Named Insured and Address Agent Name and Address Jenova Hoelscher Berger Insurance Associates, LLC 1815 SW 5th Avenue 120 Sw 5th Ave Okeechobee, FL 34974 Okeechobee, FL 34974 (863) 467-1090 (863) 763-6411 Insured Location 1815 SW 5TH AVE OKEECHOBEE, FL 34974 OKEECHOBEE COUNTY Premium Summary Basic Coverages Attached Endorsements Total Policy Premium Premium Premium Assessments / Surcharges MGA Fees/Policy Fees (Including Assessments & Surcharges) $5,988.00 ($3,781.00) $1,632.00 $27.00 $3,866.00 Rating Information Townhouse/ Number of Protection Form Construction Year Rowhouse Families Occupied Class Territory BCEG H03 Masonry 1980 N 1 Y 3 555 99 Dwelling Personal Property Protective Device Credits: County Replacement Cost Replacement Cost Burglar Fire Sprinkler Okeechobee Y Y Y N N We will provide the insurance described in this policy in return for the premium and compliance with all applicable provisions of this policy. For renewals: If we elect to continue this insurance, we will renew this policy if you pay the required renewal premium for each successive policy period subject to our premiums, rules and forms then in effect. You must pay us prior to the end of the current policy period or else this policy will expire. Insurance is provided only with respect to the following coverages for which a limit of liability is specified, subject to all the conditions of this policy. m ._. ___..... _._ LIMITT COVERAGES - SECTION I LIMITS PREMIUMS COVERAGES - SECTIO N II S PREMIUMS 11 Coverage A - Dwelling $380,671 $5,988.00 Coverage E - Personal Liability $300,000 $18.00 Coverage B - Other Structure $38,076 Coverage F Medical Payments $3,000 $5.00 ..n.� a�._..._ Coverage C - Personal Pro a Property $190, 336 p Coverage D - Loss of Use $76,135 NOTE: The portion of your premium for hurricane coverage is: $1,622.72 The portio_ n of your premium for all other coverages is: $2,243.28 Section I Coverages Subject to a 2.0% of Coverage A - $7,613 Hurricane Deductible Per Calendar Year. Section I Coverages Subject to $1,000 All Other Perils (Non-Hurricane, Non-Sinkhole) Deductible Per Loss. The Ordinance or Law Coverage amount is 25% of Coverage A - $95,168 THIS POLICY CONTAINS A SEPARATE DEDUCTIBLE FOR HURRICANE LOSSES WHICH MAY RESULT IN HIGH OUT- OF-POCKET EXPENSES TO YOU. Flood coverage is not provided by Universal Property & Casualty Insurance Company and is not part of this policy. Berger Insurance Associates, LLCpA06 Countersignature Date Chief Executive Officer UPCIC HO DEC 15 02 20 Printed Date: 6/22/2021 2:54:35 AM 1 of 3 0 CD 0 Universal Property & Casualty Insurance Company, UNIVERSAL A Stock Company Mortgagee/Additional Interest 01 Mortgagee/Additional Interest 02 Mortgagee/Additional Interest 03 City of Okeechobee Declaration Effective PROPERTY c/o Evolution Risk Advisors, Inc. 1110 W. Commercial Blvd 6/21/2021 Fort Lauderdale, FL 33309 AMENDED: Insured Change THIS IS NOT A BILL Policy Number FROM Policy Period TO INSURED BILLED Agent Code 1501-1201-6377 06/12/2021 06/12/2022 12:01 AM Standard Time BQ77 YOUR POLICY PROVIDES COVERAGE FOR A CATASTROPHIC GROUND COVER COLLAPSE THAT RESULTS IN THE PROPERTY BEING CONDEMNED AND UNINHABITABLE. OTHERWISE, YOUR POLICY DOES NOT PROVIDE COVERAGE FOR SINKHOLE LOSSES. YOU MAY PURCHASE ADDITIONAL COVERAGE FOR SINKHOLE LOSSES FOR AN ADDITIONAL PREMIUM. UPCIC HO DEC 15 02 20 Printed Date: 6/22/2021 2:54:36 AM 2 of 3 Additional Interest Mortgagee/Additional Interest 01 Mortgagee/Additional Interest 02 Mortgagee/Additional Interest 03 City of Okeechobee 55 SE 3rd Ave Okeechobee, FL 34974 Additional Insured Policy Forms & Endorsements Applicable to This Policy NUMBER EDITION DESCRIPTION LIMITS PREMIUMS UPCIC H03 15 05 18 Homeowners 3 Special Form $5,988.00 UPCIC 905 15 03 18 Outline of Your Homeowner Policy UPCIC 801 15 12 17 Windstorm Protective Devices ($4,592.00) UPCIC 406 15 05 18 Personal Property Replacement Cost $905.00 UPCIC 702 15 05 18 Additional Insured - Residence Premises UPCIC 802 1512 17 Premises Alarm or Fire Protection System ($117.00) UPCIC 201 1502 18 Calendar Year Hurricane Deductible With Supplemental Reporting Requirement - Florida UPCIC 601 1512 17 No Coverage for Home Day Care Business Year Built Surcharge $1,632.00 Personal Liability Increase Endorsement $300,000 $18.00 Medical Payment Increase Endorsement $3,000 $5.00 Emergency Management Preparedness Assistance Trust Fund $2.00 MGA Fee $25.00 YOUR POLICY PROVIDES COVERAGE FOR A CATASTROPHIC GROUND COVER COLLAPSE THAT RESULTS IN THE PROPERTY BEING CONDEMNED AND UNINHABITABLE. OTHERWISE, YOUR POLICY DOES NOT PROVIDE COVERAGE FOR SINKHOLE LOSSES. YOU MAY PURCHASE ADDITIONAL COVERAGE FOR SINKHOLE LOSSES FOR AN ADDITIONAL PREMIUM. UPCIC HO DEC 15 02 20 Printed Date: 6/22/2021 2:54:36 AM 2 of 3 Universal Property & Casualty Insurance Company, UNIVERSAL A Stock Company c/o Evolution Risk Advisors, Inc. Declaration Effective PROPERTY 4 1110 W. Commercial Blvd E CeSuN]'y IRlLRl",:H C01IYTSS 6/21/2021 Fort Lauderdale, FL 33309 AMENDED: Insured Change THIS IS NOT A BILL Policy Number FROM Policy Period TO INSURED BILLED Agent Code 1501-1201-6377 06/12/2021 06/12/2022 12:01 AM Standard Time BQ77 PLEASE VISIT UNIVERSALPROPERTY.COM TO VIEW YOUR APPLICABLE POLICY FORMS AND ENDORSEMENTS. LOG IN AND CLICK MY POLICIES/POLICY DETAILS OR TYPE THIS URL INTO YOUR INTERNET BROWSER: HTTPS://UNIVERSALPROPERTY.COM/ACCOUNT/LOGIN. YOU HAVE THE RIGHT TO CD REQUEST AND OBTAIN WITHOUT CHARGE A PAPER OR ELECTRONIC COPY OF YOUR POLICY AND ENDORSEMENTS BY CONTACTING YOUR AGENT OR CALLING CUSTOMER SERVICE AT 1-800-425-9113. LAW AND ORDINANCE: LAW AND ORDINANCE COVERAGE IS AN IMPORTANT COVERAGE THAT YOU MAY WISH TO PURCHASE. PLEASE DISCUSS WITH YOUR INSURANCE AGENT. FLOOD INSURANCE: YOU MAY ALSO NEED TO CONSIDER THE PURCHASE OF FLOOD INSURANCE. YOUR HOMEOWNER'S INSURANCE POLICY DOES NOT INCLUDE COVERAGE FOR DAMAGE RESULTING FROM FLOOD EVEN IF HURRICANE WINDS AND RAIN CAUSED THE FLOOD TO OCCUR. WITHOUT SEPARATE FLOOD INSURANCE COVERAGE, YOU MAY HAVE UNCOVERED LOSSES CAUSED BY FLOOD. PLEASE DISCUSS THE NEED TO PURCHASE SEPARATE FLOOD INSURANCE COVERAGE WITH YOUR INSURANCE AGENT. COINSURANCE CONTRACT: THIS POLICY CONTAINS A CO - PAY PROVISION THAT MAY RESULT IN HIGH OUT-OF- POCKET EXPENSES TO YOU. IMPORTANT: This replaces all previously issued policy declarations, if any and is subject to all forms and endorsements attached to this policy. UPCIC HO DEC 15 02 20 Printed Date: 6/22/2021 2:54:36 AM 3 of 3 Universal Property & Casualty Insurance Company, A Stock Homeowners UNIVERSAL Company Declaration Effective PROPERTY c/o Evolution Risk Advisors, Inc. 1110 W. Commercial Blvd 06/12/2020 1�'til'Itn�'(!: Fort Lauderdale, FL 33309 Renewal Policy THIS IS NOT A BILL For Policy or Claims Questions Contact Your Agent Listed Below Policy NumberFROM Policy Period TO INSURED BILLED Agent Code 1501-1201-6377 1 06/12/2020 06/12/2021 12:01 AM Standard Time BQ77 Named Insured and Address Agent Name and Address Jenova Hoelsher Berger Insurance Associates, LLC 1815 SW 5th Avenue 425 SW Park Street Okeechobee, FL 34974 Okeechobee, FL 34974 (863) 467-1090 (863) 763-6411 Insured Location 1815 SW 5TH AVE OKEECHOBEE, FL 34974 OKEECHOBEE COUNTY Premium Summary Basic Coverages Attached Endorsements Total Policy Premium Premium Premium Assessments / Surcharges MGA Fees/Policy Fees (Including Assessments & Surcharges) $4,392.00 ($2,784.00) $1,201.00 $27.00 $2,836.00 Rating Information Townhouse/ Number of Protection Form Construction Year Rowhouse Families Occupied Class Territory BCEG H03 Masonry 1980 N 1 Y 3 555 99 Dwelling Personal Property Protective Device Credits: County Replacement Cost Replacement Cost Burglar Fire Sprinkler Okeechobee Y Y Y N N We will provide the insurance described in this policy in return for the premium and compliance with all applicable provisions of this policy. For renewals: if we elect to continue this insurance, we will renew this policy if you pay the required renewal premium for each successive policy period subject to our premiums, rules and forms then in effect. You must pay us prior to the end of the current policy period or else this policy will expire. Insurance is provided only with respect to the following coverages for which a limit of liability is specified, subject to all the conditions of this policy. COVERAGES - SECTION I LIMITS PREMIUMS COVERAGES - SECTION II LIMITS PREMIUMS Coverage A - Dwelling $366,382 $4,392.00 Coverage E Personal Liability $300,000 $18.00 Coverage B - Other Structure $36,646 Coverage F - Medical Payments $3,000 $5.00 Coverage C Personal Property $183,191 Coverage D Loss of Use $73,277 NOTE: The portion of your premium for hurricane coverage is: $1,199.82 The portion of your premium for all other coverages is: $1,636.18 Section I Coverages Subject to a Minimum 2.0% - $7,328 Hurricane Deductible Per Calendar Year. Section I Coverages Subject to $1,000 All Other Perils (Non Hurricane, Non Sinkhole) Deductible Per Loss. The Ordinance or Law Coverage amount is 25% - $91,596 THIS POLICY CONTAINS A SEPARATE DEDUCTIBLE FOR HURRICANE LOSSES WHICH MAY RESULT IN HIGH OUT- OF-POCKET EXPENSES TO YOU. ..,� provided b Universal Property ty& Casualty Insurance Company and is not part of this policy. Flood coverage is noty Jeff Polivchak-^``~`� Countersignature Date Chief Executive Officer UPCIC HO DEC 1511 18 Printed Date: 4/23/2020 3:04:19 AM 1 of 3 Universal Property & Casualty Insurance Company, A Stock AN& f UNIVERSAL Company Mortgagee/Additional Interest 01 Mortgagee/Additional Interest 02 Mortgagee/Additional Interest 03 City of Okeechobee Declaration Effective PROPERTY c/o Evolution Risk Advisors, Inc. 55 SE 3rd Ave 1110 W. Commercial Blvd 06/12/2020 a,..,,• - Fort Lauderdale, IFL 33309 Renewal Policy THIS IS NOT A BILL Policy Number FROM Policy Period TO INSURED BILLED Agent Code 1501-1201-6377 06/12/2020 06/12/2021 12:01 AM Standard Time BQ77 YOUR POLICY PROVIDES COVERAGE FOR A CATASTROPHIC GROUND COVER COLLAPSE THAT RESULTS IN THE PROPERTY BEING CONDEMNED AND UNINHABITABLE. OTHERWISE, YOUR POLICY DOES NOT PROVIDE COVERAGE FOR SINKHOLE LOSSES. YOU MAY PURCHASE ADDITIONAL COVERAGE FOR SINKHOLE LOSSES FOR AN ADDITIONAL PREMIUM. UPCIC HO DEC 15 1•I 18 Printed Date: 4/23/2020 3:04:19 AM 2 of 3 Additional Interest Mortgagee/Additional Interest 01 Mortgagee/Additional Interest 02 Mortgagee/Additional Interest 03 City of Okeechobee 55 SE 3rd Ave Okeechobee, FL 34974 Additional Insured Policy Forms & Endorsements Applicable to This Policy NUMBER EDIT1014 DESCRIPTION LIMITS PREMIUMS UPCIC H03 15 05 18 Homeowners 3 Special Form $4,392.00 UPCIC 905 15 03 18 Outline of Your Homeowner Policy UPCIC 801 1512 17 Windstorm Protective Devices ($3,387.00) UPCIC 406 1505 18 Personal Property Replacement Cost $664.00 UPCIC 702 1505 18 Additional Insured - Residence Premises UPCIC 802 1512 17 Premises Alarm or Fire Protection System ($84.00) UPCIC 201 1502 18 Calendar Year Hurricane Deductible With Supplemental Reporting Requirement - Florida UPCIC 601 15 12 17 No Coverage for Home Day Care Business Year Built Surcharge $1,201.00 Personal Liability Increase Endorsement $300,000 $18.00 Medical Payment Increase Endorsement $3,000 $5.00 Emergency Management Preparedness Assistance Trust Fund $2.00 MGA Fee $25.00 YOUR POLICY PROVIDES COVERAGE FOR A CATASTROPHIC GROUND COVER COLLAPSE THAT RESULTS IN THE PROPERTY BEING CONDEMNED AND UNINHABITABLE. OTHERWISE, YOUR POLICY DOES NOT PROVIDE COVERAGE FOR SINKHOLE LOSSES. YOU MAY PURCHASE ADDITIONAL COVERAGE FOR SINKHOLE LOSSES FOR AN ADDITIONAL PREMIUM. UPCIC HO DEC 15 1•I 18 Printed Date: 4/23/2020 3:04:19 AM 2 of 3 Universal Property & Casualty Insurance Company, A Stock UNIVERSAL Company Declaration Effective PROPERTY c/o Evolution Risk Advisors, Inc. 1110 W. Commercial Blvd 06/12/2020 Fort Lauderdale, FL 33309 Renewal Policy THIS IS NOT A BILL Policy Number FROM Policy Period TO INSURED BILLED Agent Code 1501-1201-6377 06/12/2020 06/12/2021 12:01 AM Standard Time BQ77 LAW AND ORDINANCE: LAW AND ORDINANCE COVERAGE IS AN IMPORTANT COVERAGE THAT YOU MAY WISH TO PURCHASE. PLEASE DISCUSS WITH YOUR INSURANCE AGENT. G) nmmmmmm FLOOD INSURANCE: YOU MAY ALSO NEED TO CONSIDER THE PURCHASE OF FLOOD INSURANCE. YOUR HOMEOWINER'S INSURANCE POLICY DOES NOT INCLUDE COVERAGE FOR DAMAGE RESULTING FROM FLOOD EVEN IF HURRICANE WINDS AND RAIN CAUSED THE FLOOD TO OCCUR. WITHOUT SEPARATE FLOOD INSURANCE COVERAGE, YOU MAY HAVE UNCOVERED LOSSES CAUSED BY FLOOD. PLEASE DISCUSS THE NEED TO PURCHASE SEPARATE FLOOD INSURANCE COVERAGE WITH YOUR INSURANCE AGENT. COINSURANCE CONTRACT: THIS POLICY CONTAINS A CO -PAY PROVISION THAT MAY RESULT IN HIGH OUT-OF-POCKET EXPENSES TO YOU. IMPORTANT: This replaces all previously issued policy declarations, if any and is subject to all forms and endorsements attached to this policy. UPCIC HO DEC 15 11 18 Printed Date: 4/23/2020 3:04:19 AM 3 of 3 Universal Property & Casualty Insurance Company 1110 W. Commercial Blvd Fort Lauderdale, FL 33309 FORWARDING SERVICE REQUESTED I'I'lll'I'I'I'll'll'III'I'llllllllllllllllll�llllllllllllll"I'll City of Okeechobee 55 SE 3rd Ave Okeechobee, FL 34974-2903 19-4578 (1/14) Universal Property & Casualty Insurance Company 1110 W. Commercial Blvd Fort Lauderdale, FL 33309 LAPSE POLICY NOTICE HOMEOWNERS Policy Number 1501-1201-6377 Insured Name and Address Jenova Hoelsher 1815 SW 5th Avenue Okeechobee, FL 34974 Insured Location 1815 SW 5th Ave Okeechobee, FL 34974 VFfl Jub; I ��' 0 Date of Notice 06/12/2020 Agent Name and Address Berger Insurance Associates, LLC 425 SW Park Street Okeechobee, FL 34974 (863) 763-6411 PAYMENT OF THE REQUIRED RENEWAL PREMIUM FOR THIS POLICY HAS NOT BEEN RECEIVED. ALL COVERAGE HAS CEASED AS OF: 6/12/2020 12:0' A.M. If payment has been remitted, please disregard this notice. If you have any further insurance needs, contact your agent. Mortgagee Name and Address City of Okeechobee 55 SE 3rd Ave Okeechobee, FL 34974 UPCIC LAP 15 11 18 06/12/2020 COVID-19 and Your Insurance Policy with Universal Property & Casualty Insurance Company Dear Jenova Hoelsher, Universal Property & Casualty Insurance Company (UPCIC) recognizes the challenges being faced around the world during this extraordinary time. As we respond to the growing concerns regarding the spread of COVID-19, we remain committed to the health and safety of our workforce and the community in which we operate. 0 0 As you may know, the Department of Insurance has requested that insurance companies make reasonable accommodations for policyholders during what we would hope to be a short-term disruption to the business environment. In some cases, this will apply to notices you may have received from us in recent weeks. We support these efforts and have taken steps to extend this opportunity to you. Although we will continue our billing process as normal, some of the important measures UPCIC is taking are: When applicable: • Providing a 30 -day payment grace period from the expected termination effective date • Waiving all penalties/fees relating to late payments • Waiving any reinstatement fees When requested: • Offering installment payment plans • Additional time to perform certain duties under the policy It is important to note that this grace period is not a waiver of any required premium payment; it is only a grace period in which to pay premium. You remain responsible for premium payments associated with your policy, including any premiums that come due during the grace period. If UPCIC does not receive your premium payment by the end of this grace period, your coverage will cease as of the originally scheduled cancellation date. If you have any questions about your policy, including the status, please visit our website at www.universalproperty.com to access your information. We encourage policyholders who may require some additional form of consideration to reach out to our Customer Service Department at 800-425-9113 to discuss how we may be able to assist. Sincerely, Universal Property & Casualty Insurance Company Universal Property & Casualty Insurance Company, A Stock Homeowners UNIVERSAL Company Declaration Effective PROPERTY c/o Evolution Risk Advisors, Inc. 1110 W. Commercial Blvd Suite 300 06/12/2019 eC�AC;\UI'y 1'GOltntifat OONIMSY Fort Lauderdale, FL 33309 Renewal Policy THIS IS NOT A BILL For Policy or Claims Questions Contact Your Agent Listed Below Policy NumberFROM Policy Period TO INSURED BILLED Agent Code 1501-1201-6377 1 06/12/2019 06/12/2020 12:01 AM Standard Time BQ77 Named Insured and Address Agent Name and Address Jenova Hoelsher Berger Insurance Associates, LLC 1815 SW 5th Avenue 425 SW Park Street Okeechobee, FL 34974 Okeechobee, FL 34974 (863) 467-1090 (863) 763-6411 Insured Location 1815 SW 5TH AVE OKEECHOBEE, FL 34974 OKEECHOBEE COUNTY Premium Summary Basic Coverages Attached Endorsements Total Policy Premium Premium Premium Assessments / Surcharges MGA Fees/Policy Fees (Including Assessments & Surcharges) $4,150.00 ($2,649.00) $1,140.00 $27.00 $2,668.00 Rating Information Townhouse/ Number of Protection Form Construction Year Rowhouse Families Occupied Class Territory BCEG H03 Masonry 1980 N 1 Y 3 555 99 Dwelling Personal Property Protective Device Credits: County Replacement Cost Replacement Cost Burglar Fire Sprinkler Okeechobee Y Y Y N N We will provide the insurance described in this policy in return for the premium and compliance with all applicable provisions of this policy. For renewals: If we elect to continue this insurance; we will renew this policy if you pay the required renewal premium for each successive policy period subject to our premiums, rules and forms then in effect. You must pay us prior to the end of the current policy period or else this policy will expire. Insurance is provided only with respect to the following coverages for which a limit of liability is specified, subject to all the conditions of this policy. _ .......... __.. . _._,. .w .....,,,....... ...... _,,._. ._.. COVERAGES - SECTION I LIMITS PREMIUMS COVERAGES - SECTION II LIMITS PREMIUMS Coverage A -Dwelling $349,267 $4,150.00 Coverage E - Personal Liability $300,000 $18.00 _....__ Coverage B - Other Structure $34,933 Coverage F - Medical Payments $3,000 $5.00 Coverage C - Personal Property $174,634 Coverage D - Loss of Use $69,854 NOTE: The portion of your premium for hurricane coverage is: $1,141.94 The portion of your premium for all other coverages is: $1,526.06 Section I Coverages Subject to a Minimum 2.0% - $6,985 Hurricane Deductible Per Calendar Year. Section I Coverages Subject to $1,000 All Other Perils (Non-Hurricane, Non-Sinkhole) Deductible Per Loss. The Ordinance or Law Coverage amount is 25% - $87,317 THIS POLICY CONTAINS A SEPARATE DEDUCTIBLE FOR HURRICANE LOSSES WHICH MAY RESULT IN HIGH OUT- OF-POCKET EXPENSES TO YOU,,.----- OU._-Flood Floodcoverage is not provided by Universal Property & Casualty Insurance Company and is not part of this policy. Jeff Polivchak Countersignature Date Chief Executive Officer UPCIC HO DEC 15 11 18 Printed Date: 4/23/2019 2:28:14 AM 1 of 3 Universal Property & Casualty Insurance Company, A Stock Rsr,� CompanyU�T�TE Mortgagee/Additional Interest 01 Mortgagee/Additional Interest 02 Mortgagee/Additional Interest 03 City of Okeechobee Declaration Effective4PROPERTY c/o Evolution Risk Advisors, Inc. 55 SE 3rd Ave 1110 W. Commercial Blvd Suite 300 06/12/2019 Fort Lauderdale, FL 33309 Renewal Policy THIS IS NOT A BILL Policy Number F FROM Policy Period TO INSURED BILLED Agent Code 1501-1201-6377 1 06/12/2019 06/12/2020 12:01 AM Standard Time BQ77 YOUR POLICY PROVIDES COVERAGE FOR A CATASTROPHIC GROUND COVER COLLAPSE THAT RESULTS IN THE PROPERTY BEING CONDEMNED AND UNINHABITABLE. OTHERWISE, YOUR POLICY DOES NOT PROVIDE COVERAGE FOR SINKHOLE LOSSES. YOU MAY PURCHASE ADDITIONAL COVERAGE FOR SINKHOLE LOSSES FOR AN ADDITIONAL PREMIUM. UPCIC HO DEC 15 11 18 Printed Date: 4/23/2019 2:28:14 AM 2 of 3 Additional Interest Mortgagee/Additional Interest 01 Mortgagee/Additional Interest 02 Mortgagee/Additional Interest 03 City of Okeechobee 55 SE 3rd Ave Okeechobee, FL 34974 Additional Insured Policy Forms & Endorsements Applicable to This Policy NUMBER EDITION DESCRIPTION LIMITS PREMIUMS UPCIC H03 15 05 18 Homeowners 3 Special Form $4,150.00 UPCIC 905 15 03 18 Outline of Your Homeowner Policy UPCIC 801 1512 17 Windstorm Protective Devices ($3,220.00) UPCIC 406 15 05 18 Personal Property Replacement Cost $627.00 UPCIC 702 15 05 18 Additional Insured - Residence Premises UPCIC 802 15,12 17 Premises Alarm or Fire Protection System ($79.00) UPCIC 201 15 02 18 Calendar Year Hurricane Deductible With Supplemental Reporting Requirement - Florida UPCIC 601 1512 17 No Coverage for Home Day Care Business Year Built Surcharge $1,140.00 Personal Liability Increase Endorsement $300,000 $18.00 Medical Payment Increase Endorsement $3,000 $5.00 Emergency Management Preparedness Assistance Trust Fund $2.00 MGA Fee $25.00 YOUR POLICY PROVIDES COVERAGE FOR A CATASTROPHIC GROUND COVER COLLAPSE THAT RESULTS IN THE PROPERTY BEING CONDEMNED AND UNINHABITABLE. OTHERWISE, YOUR POLICY DOES NOT PROVIDE COVERAGE FOR SINKHOLE LOSSES. YOU MAY PURCHASE ADDITIONAL COVERAGE FOR SINKHOLE LOSSES FOR AN ADDITIONAL PREMIUM. UPCIC HO DEC 15 11 18 Printed Date: 4/23/2019 2:28:14 AM 2 of 3 Universal Property & Casualty Insurance Company, A Stock UNIVERSAL Company Declaration Effective PROPERTY c/o Evolution Risk Advisors, Inc. 1110 W. Commercial Blvd Suite 300 06/12/2019 ""'°'""""" Fort Lauderdale, FL 33309 Renewal Policy THIS IS NOT A BILL Policy Number FROM Policy Period TO INSURED BILLED Agent Code 1501-1201-6377 1 06/12/2019 06/12/2020 1 12:01 AM Standard Time BQ77 LAW AND ORDINANCE: LAW AND ORDINANCE COVERAGE IS AN IMPORTANT COVERAGE THAT YOU MAY WISH TO PURCHASE. PLEASE °-- DISCUSS WITH YOUR INSURANCE AGENT. G) FLOOD INSURANCE: YOU MAY ALSO NEED TO CONSIDER THE PURCHASE OF FLOOD INSURANCE. YOUR HOMEOWNER'S INSURANCE POLICY DOES NOT INCLUDE COVERAGE FOR DAMAGE RESULTING FROM FLOOD EVEN IF HURRICANE WINDS AND RAIN CAUSED THE FLOOD TO OCCUR. WITHOUT SEPARATE FLOOD INSURANCE COVERAGE, YOU MAY HAVE UNCOVERED LOSSES CAUSED BY FLOOD. PLEASE DISCUSS THE NEED TO PURCHASE SEPARATE FLOOD INSURANCE COVERAGE WITH YOUR INSURANCE AGENT. COINSURANCE CONTRACT: THIS POLICY CONTAINS A CO -PAY PROVISION THAT MAY RESULT IN HIGH OUT-OF-POCKET EXPENSES TO YOU. IMPORTANT: This replaces all previously issued policy declarations, if any and is subject to all forms and endorsements attached to this policy. UPCIC HO DEC 15 11 18 Printed Date: 4/23/2019 2:28:14 AM 3 of 3 Universal Property & Casualty Insurance Company Homeowners c/o Universal Risk Advisors Declaration EffectiveOMWD 1110 W. Commercial Blvd Suite 300 06/12/2017 Fort Lauderdale, FL 33309 Toll Free: 800-425-9113 Renewal Policy Claims: 800-218-3206 Service: Contact your Agent Listed Below Policy Number FROM Policy Period TO INSURED BILLED Agent Code 1501-1201-6377 06/12/2017 06/12/2018 1 12:01 AM Standard Time BQ77 Named Insured and Address Jenova Hoelsher 1815 SW 5th Avenue Okeechobee, FL 34974 (863) 467-1090 Premium Summary Basic Coverages Attached Endorsements Agent Name and Address Berger Insurance Associates, LLC 425 SW Park Street Okeechobee, FL 34974 (863) 763-6411 Premium Premium Assessments / Surcharges MGA Fees/Policy Fees $3,154.00 ($2,030.00) $871.00 $27.00 Location 001 Townhouse/ Number of Form Construction Year Rowhouse Families H03 Masonry 1980 N 1 Dwelling County Replacement Cost Home Updated Okeechobee Y Y Total Policy Premium (Including Assessments & Surcharges) $2,022.00 Protection Occupied Class Territory BCEG Y 3 555 99 Protective Device Credits: Wind / Hail Burglar Fire Sprinkler Shutter Exclusion Central None N N N We will provide the insurance described in this policy in return for the premium and compliance with all applicable provisions of this policy. If we elect to continue this insurance, we will renew this policy if you pay the required renewal premium for each successive policy period subject to our premiums, rules and forms then in effect. You must pay us prior to the end of the current policy period or else this policy will expire. Insurance is provided only with respect to the following coverages for which a limit of liability is specified, subject to all the conditions of this policy. COVERAGES - SECTION I LIMITS PREMIUMS COVERAGES - SECTION II LIMITS PREMIUMS Coverage -A- Dwelling $316,808 $3,154.00 Coverage -E- Personal Liability $300,000 $18.00 Coverage -B- Other Structure $31,685 Coverage -F- Medical Payments $3,000 $5.00 Coverage -C- Personal Property $158,404 Coverage -D- Loss of Use $63,362 NOTE: The portion of your premium for hurricane coverage is: $878.12 The portion of your premium for all other coverages is: $1,143.88 Section 1 coverages subject to a minimum 2.0% - $6,336 hurricane deductible per calendar year. Section 1 coverages subject to $1,000 non -hurricane (non -sinkhole) deductible per loss. DESCRIBED LOCATION - The Described Location covered by this policy is at the above address unless otherwise stated: 1815 SW 5th Ave Okeechobee, FL 34974 THIS POLICY CONTAINS A SEPARATE DEDUCTIBLE FOR HURRICANE LOSSES WHICH MAY RESULT IN HIGH OUT- OF-POCKET EXPENSES TO YOU. Flood coverage is not provided by Universal Property and Casualty Insurance Company and is not part of this policy. Countersignature Date Chief Executive Officer UPC: c HO 1 c C2 12 n[- ;! D ._ 41/23/20117 %'31 of 3 Universal Property & Casualty Insurance Company c/o Universal Risk Advisors Declaration Effectivezw=�) 1110 W. Commercial Blvd Suite 300 06/12/2017 Fort Lauderdale, FL 33309 Renewal Policy Toll Free: 800-425-9113 Claims: 800-218-3206 Service: Contact your Agent Listed Below Policy Number FROM Policy Period TO INSURED BILLED Agent Code 1501-1201-6377 06/12/2017 06/12/2018 12:01 AM Standard Time BQ77 YOUR POLICY PROVIDES COVERAGE FOR A CATASTROPHIC GROUND COVER COLLAPSE THAT RESULTS IN THE PROPERTY BEING CONDEMNED AND UNINHABITABLE. OTHERWISE, YOUR POLICY DOES NOT PROVIDE COVERAGE FOR SINKHOLE LOSSES. YOU MAY PURCHASE ADDITIONAL COVERAGE FOR SINKHOLE LOSSES FOR AN ADDITIONAL PREMIUM. This rnolaces all prcViou,:y issued 00liCy (Ir r3 +at; ns i` nny a ;'W'jert to all orris and endorsc rr - Trached to th3, po&i y. Universal Property and Casualty Insurance Company Homeowners c/o Universal Risk Advisors Declaration Effective 1110 W. Commercial Blvd Suite 300 06/12/2016 Fort Lauderdale, FL 33309 Renewal Policy Toll Free: 800-425-9113 Claims: 800-218-3206 Service: Contact your Agent Listed Below Policy Number FROM Policy Period TO INSURED BILLED Agent Code 1501-1201-6377 06/12/2016 06/12/2017 12:01 AM Standard Time BQ77 Named Insured and Address Agent Name and Address Jenova Hoelsher Berger Insurance Associates, LLC 1815 SW 5th Avenue 425 SW Park Street Okeechobee, FL 34974 Okeechobee, FL 34974 (863) 467-1090 (863) 763-6411 Premium Summary Basic Coverages Attached Endorsements Total Policy Premium Premium Premium Assessments / Surcharges MGA Fees/Policy Fees (Including Assessments & Surcharges) $3,072.00 ($1,981.00) $849.00 $27.00 $1,967.00 Location 001 Townhouse/ Number of Protection Form Construction Year Rowhouse Families Occupied Class Territory BCEG H03 Masonry 1980 N 1 Y 3 555 99 Dwelling Protective Device Credits: Wind / Hail County Replacement Cost Home Updated Burglar Fire Sprinkler Shutter Exclusion Okeechobee Y Y Central None N N N We will provide the insurance described in this policy in return for the premium and compliance with all applicable provisions of this policy. If we elect to continue this insurance, we will renew this policy if you pay the required renewal premium for each successive policy period subject to our premiums, rules and forms then in effect. You must pay us prior to the end of the current policy period or else this policy will expire. Insurance is provided only with respect to the following coverages for which a limit of liability is specified, subject to all the conditions of this policy. COVERAGES - SECTION I LIMITS PREMIUMS COVERAGES - SECTION II LIMITS PREMIUMS Coverage -A- Dwelling $309,382 $3,072.00 Coverage -E- Personal Liability $300,000 $18.00 Coverage -B- Other Structure $30,942 Coverage -F- Medical Payments $3,000 $5.00 Coverage -C- Personal Property $154,691 Coverage -D- Loss of Use $61,877 NOTE: The portion of your premium for hurricane coverage is: $857.16 The portion of your premium for all other coverages is: $1,109.84 Section 1 coverages subject to a minimum 2.0% - $6,188 hurricane deductible per calendar year. Section 1 coverages subject to $1,000 non -hurricane (non -sinkhole) deductible per loss. DESCRIBED LOCATION - The Described Location covered by this policy is at the above address unless otherwise stated: 1815 SW 5th Ave Okeechobee, FL 34974 THIS POLICY CONTAINS A SEPARATE DEDUCTIBLE FOR HURRICANE LOSSES WHICH MAY RESULT IN HIGH OUT- OF-POCKET EXPENSES TO YOU. Flood coverage is not provided by Universal Property and Casualty Insurance Company and is not part of this policy. Countersignature Date Chief Executive Officer UPCIC HO Dec 02 12 Printed Date: 4/23/2016 3:00:23 AM 1 of 3 Universal Property and Casualty Insurance Company c/o Universal Risk Advisors Declaration Effective t`' t 1110 W. Commercial Blvd Suite 300 y ��i, 06/12/2016 990 1 Fort Lauderdale, FL 33309 Renewal Policy Toll Free: 800-425-9113 Claims: 800-218-3206 Service: Contact your Agent Listed Below Policy Number FROM Policy Period TO INSURED BILLED Agent Code 1501-1201-6377 06/12/2016 06/12/2017 12:01 AM Standard Time B077 YOUR POLICY PROVIDES COVERAGE FOR A CATASTROPHIC GROUND COVER COLLAPSE THAT RESULTS IN THE PROPERTY BEING CONDEMNED AND UNINHABITABLE, OTHERWISE, YOUR POLICY DOES NOT PROVIDE COVERAGE FOR SINKHOLE LOSSES. YOU MAY PURCHASE ADDITIONAL COVERAGE FOR SINKHOLE LOSSES FOR AN ADDITIONAL 0, PREMIUM. This replaces all previously issued policy declarations, if any and is subject to all forms and endorsements attached to this policy. UPCIC HO Dec 02 12 Printed Date: 4/23/2016 3:00:23 AM 3 of 3 Universal Property & Casualty Insurance Company c/o Universal Risk Advisors Declaration Effectivaww� 1110 W. Commercial Blvd Suite 300 06/12/2017 Fort Lauderdale, FL 33309 Renewal Policy Toll Free: 800-425-9113 Claims: 800-218-3206 Service: Contact your Agent Listed Below Policy Number FROM Policy Period TO INSURED BILLED Agent Code 1501-1201-6377 06/12/2017 06/12/2018 12:01 AM Standard Time BQ77 Mortgagee / Additional Interest 01 City of Okeechobee 55 SE 3rd Ave Okeechobee, FL 34974 Additional Interest Mortgagee/Additional Interest 01 Mortgagee/Additional Interest 02 City of Okeechobee 55 SE 3rd Ave Okeechobee. FL 34974 NUMBER EDITION HO 00 03 04 91 UPCIC 03 33 07 08 UPCIC 3 01 98 UPCIC 25 01 98 (06-07) UPCIC 23 08 16 UPCIC 19 01 98 UPCIC 16 01 98 HO 04 96 04 91 UPCIC 04 90 04 91 (06-07) HO 04 48 04 91 HO 04 16 04 91 UPCIC 10 01 98 (06-07) HO 04 41 04 91 Agent Name and Address Berger Insurance Associates, LLC 425 SW Park Street Okeechobee, FL 34974 (863)763-6411 Mortgagee/Additional Interest 03 Policy Forms and Endorsements Applicable to this Policy DESCRIPTION Homeowners 3 Special Form Limited Fungi, Wet or Dry Rot, or Bacteria Section I - $10,0001$20.000, Section II - $50,000 Outline of Your Homeowner Policy Hurricane Deductible Special Provisions - Florida Windstorm Protective Devices Loss Assessment Coverage No Coverage for Home Day Care Business Personal Property Replacement Cost Other Structures Premises Alarm or Fire Protection System Existing Damage Exclusion Year Built Surcharge Personal Liability Increase Endorsement Medical Payment Increase Endorsement Additional Insured - Residence Premises Emergency Management Preparedness Assistance Trust Fund MGA Fee LIMITS PREMIUMS $3.154.00 ($2,47200) $1.000 $158,404 $477.00 $31,685 ($58.00) $871.00 $300,000 $18.00 $3,000 $5.00 $2.00 $25.00 LAW AND ORDINANCE COVERAGE IS AN IMPORTANT COVERAGE THAT YOU MAY WISH TO PURCHASE. YOU MAY ALSO NEED TO CONSIDER THE PURCHASE OF FLOOD INSURANCE FROM THE NATIONAL FLOOD INSURANCE PROGRAM. WITHOUT THIS COVERAGE, YOU MAY HAVE UNCOVERED LOSSES. PLEASE DISCUSS THESE COVERAGES WITH YOUR INSURANCE AGENT. COINSURANCE CONTRACT: THIS POLICY CONTAINS A CO -PAY PROVISION THAT MAY RESULT IN HIGH OUT-OF- POCKET EXPENSES TO YOU. UPCIC HO Dec 02 12 Printed Dale: 4; 701 7 2:37::55 ASA 2 c 3 Universal Property and Casualty Insurance Company c/o Universal Risk Advisors Declaration Effectivei[', I o; 1110 W. Commercial Blvd Suite 300 06/12/2016 Fort Lauderdale, FL 33309 Toll Free: 800-425-9113 Renewal Policy Claims: 800-218-3206 Service: Contact your Agent Listed Below Policy Number FROM Policy Period TO INSURED BILLED Agent Code 1501-1201-6377 06/12/2016 06/12/2017 12:01 AM Standard Time B077 Mortgagee / Additional Interest 01 Agent Name and Address City of Okeechobee Berger Insurance Associates, LLC 55 SE 3rd Ave 425 SW Park Street Okeechobee, FL 34974 Okeechobee, FL 34974 (863) 763-6411 Additional Interest Mortgagee/Additional Interest 01 Mortgagee/Additional Interest 02 Mortgagee/Additional Interest 03 City of Okeechobee 55 SE 3rd Ave Okeechobee, FL 34974 Policy Forms and Endorsements Applicable to this Policy NUMBER EDITION DESCRIPTION LIMITS PREMIUMS HO 00 03 04 91 Homeowners 3 Special Form $3,072.00 UPCIC 03 33 07 08 Limited Fungi, Wet or Dry Rot, or Bacteria Section 1- $10,000/$20,000; Section II - $50,000 UPCIC 3 01 98 Outline of Your Homeowner Policy UPCIC 25 01 98 (06-07) Hurricane Deductible UPCIC 23 01 16 Special Provisions - Florida UPCIC 19 01 98 Windstorm Protective Devices ($2,411.00) UPCIC 16 01 98 Loss Assessment Coverage $1,000 HO 04 96 04 91 No Coverage for Home Day Care Business UPCIC 04 90 04 91 (06-07) Personal Property Replacement Cost $154,691 $464.00 HO 04 48 04 91 Other Structures $30,942 HO 04 16 04 91 Premises Alarm or Fire Protection System ($57.00) UPCIC 10 01 98 (06-07) Existing Damage Exclusion Year Built Surcharge $849.00 Personal Liability Increase Endorsement $300,000 $18.00 Medical Payment Increase Endorsement $3,000 $5.00 HO 04 41 04 91 Additional Insured - Residence Premises Emergency Management Preparedness Assistance Trust Fund $2.00 MGA Fee $25.00 LAW AND ORDINANCE COVERAGE IS AN IMPORTANT COVERAGE THAT YOU MAY WISH TO PURCHASE. YOU MAY ALSO NEED TO CONSIDER THE PURCHASE OF FLOOD INSURANCE FROM THE NATIONAL FLOOD INSURANCE PROGRAM. WITHOUT THIS COVERAGE, YOU MAY HAVE UNCOVERED LOSSES. PLEASE DISCUSS THESE COVERAGES WITH YOUR INSURANCE AGENT. COINSURANCE CONTRACT: THIS POLICY CONTAINS A CO -PAY PROVISION THAT MAY RESULT IN HIGH OUT-OF- POCKET EXPENSES TO YOU. UPCIC HO Dec 02 12 Printed Date: 4/23/2016 3:00:23 AM 2 of 3 e Universal Property and Casualty Insurance Company Homeowners c/o Universal Risk Advisors Declaration Effective t t 1110 W. Commercial Blvd Suite 300 t . 06/12/2014 Fort Lauderdale, FL 33309 Renewal Policy Toll Free: 800-425-9113 Claims: 800-218-3206 Service: Contact your Agent Listed Below Policy Number FROM Policy Period TO INSURED BILLED Agent Code 1501-1201-6377 1 06/12/2014 06/12/2015 12:01 AM Standard Time BQ77 Named Insured and Address Jenova Hoelsher 1815 SW 5th Avenue Okeechobee, FL 34974 863-467-1090 Basic Coverages Attached Endorsements Premium Premium Agent Name and Address Berger Insurance Associates, LLC 800 South Parrott Ave. Okeechobee, FL 34974 8637636411 Premium Summary Total Policy Premium Assessments / Surcharges MGA Fees/Policy Fees (Including Assessments & Surcharges) $2,551.00 ($1,649.00) $707.00 $64.81 Location 001 $1,673.81 Townhouse/ Number of Protection Form Construction Year Rowhouse Families Occupied Class Territory BCEG H03 Masonry 1980 N 1 Y 3 555 99 Dwelling Protective Device Credits: Wind / Hail County Replacement Cost Home Updated Burglar Fire Sprinkler Shutter Exclusion Okeechobee Y Y Y N N N N We will _ --- II provide the insurance described in this policy in return for the premium and compliance with all applicable provisions of this policy. If we elect to continue this insurance, we will renew this policy if you pay the required renewal premium for each successive policy period subject to our premiums, rules and forms then in effect. You must pay us prior to the end of the current policy period or else this policy will expire. Insurance is provided only with respect to the following coverages for which a limit of liability is specified, subject to all the conditions of this policy. COVERAGES - SECTION I LIMITS PREMIUMS COVERAGES - SECTION II LIMITS PREMIUMS Coverage -A- Dwelling $284,352 $2,551.00 Coverage -E- Personal Liability $300,000 $18.00 Coverage -B- Other Structure $28,438 Coverage -F- Medical Payments $3,000 $5.00 Coverage -C-Personal Property $142,176 Coverage -D- Loss of Use $56,871 NOTE: The portion of your premium for hurricane coverage is: $717.25 The portion of your premium for all other coverages is: $956.56 Section 1 coverages subject to a minimum 2.0% - $5,687 hurricane deductible per calendar year. Section 1 coverages subject to $1,000 non -hurricane (non -sinkhole) deductible per loss. DESCRIBED LOCATION - The Described Location covered by this policy is at the above address unless otherwise stated: 1815 SW 5th Ave Okeechobee, FL 34974 THIS POLICY CONTAINS A SEPARATE DEDUCTIBLE FOR HURRICANE LOSSES WHICH MAY RESULT IN HIGH OUT-OF-POCKET EXPENSES TO YOU. Flood coverage is not provided by Universal Property and Casualty Insurance Company and is not part of this policy. Date Chief 6perating Officer UPCIC HO Dec 02 12 Printed Date: 4/23/2014 2:35:26 AM 1 of 3 l Universal Property and Casualty Insurance Company c/o Universal Risk Advisors Declaration Effective 1110 W. Commercial Blvd Suite 300 06/12/2014 Fort Lauderdale, FL 33309 Renewal Policy Toll Free: 800-425-9113 Claims: 800-218-3206 Service: Contact your Agent Listed Below Policy Number FROM Policy Period TO INSURED BILLED Agent Code 1501-1201-6377 06/12/2014 06/12/2015 12:01 AM Standard Time BQ77 Mortgagee / Additional Interest 01 City of Okeechobee 55 SE 3rd Ave Okeechobee, FL 34974 Mortgagee/Additional Interest 01 City of Okeechobee 55 SE 3rd Ave Okeechobee, FL 34974 Agent Name and Address Berger Insurance Associates, LLC 800 South Parrott Ave. Okeechobee, FL 34974 8637636411 Additional Interest Mortgagee/Additional Interest 02 Mortgagee/Additional Interest 03 Policy Forms and Endorsements Applicable to this Policy NUMBER EDITION DESCRIPTION LIMITS PREMIUMS HO 00 03 04 91 Homeowners 3 Special Form $2,551.00 UPCIC 03 33 07 08 Limited Fungi, Wet or Dry Rot, or Bacteria Section 1- $10,000/$20,000; Section II - $50,000 UPCIC 3 01 98 Outline of Your Homeowner Policy UPCIC 25 01 98 (06-07) Hurricane Deductible UPCIC 23 12 13 Special Provisions - Florida UPCIC 19 01 98 Windstorm Protective Devices ($2,011.00) UPCIC 16 01 98 Loss Assessment Coverage $1,000 HO 04 96 04 91 No Coverage for Home Day Care Business UPCIC 04 90 04 91 (06-07) Personal Property Replacement Cost $142,176 $385.00 HO 04 48 04 91 Other Structures $28,438 HO 04 41 04 91 Additional Insured - Residence Premises HO 04 16 04 91 Premises Alarm or Fire Protection System ($46.00) Year Built Surcharge $707.00 Personal Liability Increase Endorsement $300,000 $18.00 Medical Payment Increase Endorsement $3,000 $5.00 Emergency Management Preparedness Assistance Trust Fund $2.00 MGA Fee $25.00 Florida Hurricane Catastrophe Fund Emergency Assessment $20.92 Citizens Emergency Assessment $16.09 2012 Florida Insurance Guaranty Association Recoupment $0.80 LAW AND ORDINANCE COVERAGE IS AN IMPORTANT COVERAGE THAT YOU MAY WISH TO PURCHASE. YOU MAY ALSO NEED TO CONSIDER THE PURCHASE OF FLOOD INSURANCE FROM THE NATIONAL FLOOD INSURANCE PROGRAM. WITHOUT THIS COVERAGE, YOU MAY HAVE UNCOVERED LOSSES. PLEASE DISCUSS THESE COVERAGES WITH YOUR INSURANCE AGENT. COINSURANCE CONTRACT: THIS POLICY CONTAINS A CO -PAY PROVISION THAT MAY RESULT IN HIGH OUT-OF-POCKET EXPENSES TO YOU. UPCIC HO Dec 02 12 Printed Date: 4/23/2014 2:35:26 AM 2 of 3 1 Universal Property and Casualty Insurance Company V c/o Universal Risk Advisors Declaration Effective I 1110 W. Commercial Blvd Suite 300 06/12/2014 Fort Lauderdale, FL 33309 Renewal Policy Toll Free: 800-425-9113 Claims: 800-218-3206 Service: Contact your Agent Listed Below Policy Number FROM Policy Period TO INSURED BILLED Agent Code 1501-1201-6377 06/12/2014 06/12/2015 12:01 AM Standard Time BQ77 YOUR POLICY PROVIDES COVERAGE FOR A CATASTROPHIC GROUND COVER COLLAPSE THAT RESULTS IN THE PROPERTY BEING CONDEMNED AND UNINHABITABLE. OTHERWISE, YOUR POLICY DOES NOT PROVIDE COVERAGE FOR SINKHOLE LOSSES. YOU MAY PURCHASE ADDITIONAL COVERAGE FOR SINKHOLE LOSSES FOR AN ADDITIONAL o PREMIUM. This replaces all previously issued policy declarations, if any and is subject to all forms and endorsements attached to this policy. UPCIC HO Dec 02 12 Printed Date: 4/23/2014 2:35:26 AM 3 of 3 1111111 lilll 1111111111111111111111111111 t{iFILE NUN 2014001186 -i t-1P''"ti.'..F:.i'?f`: OKEECHOBEE COUNTY: FLORIDA RECORDED 02/03/2014 03:15:52 PM ti :i.;URC3.hiii FEES $1 u!ili P.3s 398 - 399; (2 P9s) LICENSE AGREEMENT THIS AGREEMENT, BY AND BETWEEN THE CITY OF OKEECHOBEE, FLORIDA, a Florida Municipal corporation (hereinafter "CITY"), 4nd JENOVA CONNER HOELSCHER, (hereinafter "OWNER(S)"), dated this � day of , 2014. WHEREAS, OWNER(S) hold fee simple title to the following described real property in Okeechobee County, Florida, to wit: Legal Description: LOTS 7 AND 8 OF BLOCK 23, WOODLAND PARK, ACCORDING TO THE PLAT THEREOF AS RECORDED IN PLAT BOOK 2, PAGE 28, PUBLIC RECORDS OF OKEECHOBEE COUNTY, FLORIDA. WHEREAS, the CITY owns the following platted street: THAT FIFTY FOOT (50') WIDE STREET KNOWN AS SOUTHWEST 18T" STREET (F/K/A SOUTHWEST 11T" STREET) LOCATED BETWEEN BLOCKS 21 AND 23 OF WOODLAND PARK SUBDIVISION, ABANDONED SOUTHWEST 6T" DRIVE (F/K/A/ WESTMORELAND DRIVE) TO THE WEST, AND SOUTHWEST 5T" AVENUE (F/K/A OSCEOLA STREET) TO THE EAST. WHEREAS, the OWNER(S) desire to make certain improvements in the form of a fence, located within the right-of-way of Southwest 18th Street and contiguous to their property. NOW, THEREFORE, in consideration of the mutual promises and covenants set forth herein, the parties agree as follows: The CITY hereby grants this revocable license for use, of the South 25 feet of Southwest 18th Street, with the understanding the OWNER(S) will maintain the right-of-way and should it ever become necessary to remove any fencing, or any improvement thereon, in order to allow either the installation, or maintenance of water, sewer, or other utility lines or any other type of installation or construction, or for any other reason chosen by the CITY, the fencing, or any improvement thereon, will be removed by the OWNER(S) or their agents and/or assigns at the OWNER(S) expense within seven days of receipt of written request by the CITY for such removal. Should the CITY, for valid reasons, require the removal of the fencing, or any improvements thereon, less than seven days notice, the OWNER(S) agrees to exercise reasonable efforts to comply with such requests. 2. OWNER(S) agree to contact their insurance company and require a rider be added to their insurance policy listing the CITY as additional insured with a Certificate of Insurance furnished to the CITY showing the portion of Southwest 18 Street right-of-way, lying North of Lots 7 and 8, of Block 23, as herein described, to be used by them, insures the CITY against any liability arising out of alleged injuries or other activities which may occur within the right-of-way. In any event, OWNER(S) agree and shall hold the CITY harmless for any and all action, suit, claim, injury or cause of action of any nature arising out of OWNER(S) permissive use, and indemnify CITY for such, including costs and attorney fees. 3. OWNER(S) agree to furnish a copy of the Certificate of Additional Insured to the CITY annually upon renewal with their insurance carrier. 4. That OWNER(S) shall not, by such improvements made to that described right- of-way, obstruct, close or otherwise restrict access to the right-of-way for travel thereon by the CITY or the general public, except as otherwise provided in this agreement. Page 1 of 2 5. That the OWNER(S) agree that this license is non -assignable without the express written consent of the CITY; and if owners sell or transfer the subject property, their covenants and agreements shall run with the land. 6. The City Clerk shall cause this license to be recorded in the public records of Okeechobee County, Florida. 7. OWNER(S) agree to reimburse the CITY all recordings costs. IN WITNESS WHEREOF, the parties hereto set their hands and seals on the aforesaid date. Signed, sealed and delivered in presence eqlwAll Q"aei enova Conner Hoelscher, Property Owner (Witness ignature) Me UISA' Joh ne /- (Witness Printed Name) '�-5 �S'r 3 d 4,0 ;LL (Witness Address) STATE OF FLORIDA COUNTY OF r'iPQrI�ChQP (Witness Signature) (Witness Printed Name) �-z (WitrYess Address) Th!Ioint4ru oregoing instrum nt was acknowledged before me this � day of , 20_1_q, by Jenova Conner Hoelscher, who signed in the presence of these witn s(es); and who produced as identification or is personally known: Accepted for the City: avid Allen, Public orks Director Reviewed for Legal Sufficiency: John R. Cook, City Attorney n Notiry Public Signature � e �l S�� 1 �1. : Q l iter Name of Notary (typed, printed or stamped) W ii�on No. FF 8x605Y MELISA M. JAHNER MY COMMISSION # EE885058 EXPIRES: Match IB. 2017 (city seal) Page 2 of 2 Lane Gam' tea, CMC, City Clerk CONTINUOUS MARRIAGE AFFIDAVIT STATE OF FLORIDA COUNTY OF OKEEC BEFORE ME, the undersigned authority, personally appeared JENOVA CONNER HOELSCHER, a married woman, who, after being duly cautioned and sworn, on her oath, deposes and states: That I am the daughter of HUBERT E. CONNER and IRENE M. CONNER, deceased. 2. That they held title to: LOTS 5 and 6 of BLOCK 23, WOODLAND PARK, according to the plat thereof recorded in plat book 2, at page 28, of the public records of Okeechobee County, Florida And LOTS 7 and 8 o OCK 23, WOODLAND PARK, according to the plat thereof recorded in pl , at page 28, of the public records of Okeechobee County, Florida. 3. That E RT E. and IRENE M. CONNER were married prior to May 1, 1980, and lived togentinuo ly a day of his death on October 20, 1997. 4. That M. CO a the sole owner of that said property by operation of law upon the death FURTHER AFFIANT SAYET STATE OF FLORIDA COUNTY OF OKEECHOBEE SWORN TO and SUBSCRIBED before me this day of , 2012, by JENOVA CONNER HOEL�SCHER, who (,) is personally known t me or produced as identific n. NOTARY My commission expires: LNM WR" Ni W COMMISSION N DD 792424 EXPIRES: July 24, 2012 Bonded Thm No" Publk Urftweem Book713/Page864 CFN#2012003598 Page 1 of 1 7DN_n mx" n a r- o;0m ;0o 4=Mh 42 M Ly hn Tlmi) M --I o N O 00 a;;0 MI` to7z rn oC3o 7) C7 V 02 cl O N t+ mew v ti c -o —4 �� 00 3 C. 00 O O �o 0 n C3 --I ;c m to m •• to0o� rr n _00 o +. r., , ►a —no o c� v-zto -t w r •• ow co M v 'v M. 3 jAll 2 OP -3401 r WARRANTY D!!D '°-(281 raE19.40 R.r�a raRN of WDIVIO, TOINDIVID =s;t15 - ivACCfl N Bad Made the day of October A. D. 1986 by D.R: DANIEL and JOE M. DANIEL, his wife hereinefier called the grantor, to HUBERT E. CONNER and IRENE M. CONNER, his wife Whose postoffice address is 1815 SW 5th Avenue, Okeechobee, Florida 33474 hereinafter called the grantee: Mlw— vwd )ten A, w— "RtRnt.!" red "Rnnwe" I,Nlud, JI tM pork, tv thh wm owns -A s the )in, IeR,I npnu uuw. Rvd an en of iced . du.l�, and ,b, vtrrmm� red wiam b Batt ar.tiomJ IWIMMeth: That the grantor, for and in consideration of the rum of S 10, 00 and other valuable consideraitons, receipt Whereof is hereby acknowledged, hereby Urania, bargains, sells, aliens, re- mises, releases, conveys and confirms unto the gronlee, all that certain land situate in Okeechobee County, Florida. vii:: Lots 7 and 8, Block 23, WOODLAND PARK, according to the plat thereof as recorded in Plat Book 2, Page 28, Public Records of Okeechobee County, Florida. SUBJECT TO: Restrictions, Reservations and Easements of Record, "T ?' a� f=�t—€3fi"1r ' .n_0i:UN1[M1ARYsT •:, STAMP T.4^ k� D FOR REOORD rtV vl` CIJ37EM'Nii,rL 1996 OCT 27 1,11 ,n: 44 GLORIA J. F i'J JJW.t 1�9e ei W(th all the tanementi, hereditaments and appurtenances thereto belonging or, In any - wise appolaining. To But and to Mold, the same in fee simple forever. glad the grantor hereby covenants With old t the grantor is lawfully seised of said land In foe simple: that the grantor has good rig an lawful or(iy ro :all and rnnttey said land; that the grantor hereby fully warrants the title to sat d and ill viand the same against the lawful claims of all persons whomsoever; and that sodd land f of al cumbrances, except fazes accruing subsequent to December 31, to 85 In IMAM 'Vhffe0f he said y t grantor has slgnad first above written. Signed, sealed and delivered delivered to out presence: QkY .., :. �u!.............................. _ ... ITN ppS i. WI 5 ............................. ..... STA F FLORIDA COUNTY of OKEECHOBEE 1 HEREBY CERTIFY that on this day, before me, an officer duly sutharised in the State aforesaid and in the County aforesaid to take achxowledrmenu, personally appeared D—R—DANIEL and JOE M. DANIEL, his wife "MeoirpN1+knonn'to; be the persons described in and who. executed the 1C f W,406meat and they acknowledged before me that they .• •tAI set". t:. WITNESS my hand and official seal in the County and OT4ny ,k.•�ute Jaq aforesaid this act day of _Qctober , A. D. 1986, ��' �'9d'lk,►�1s1'rur t�n,{t1 =3Addrru .Z. presents the day and year NUTARY FVPL�g' My Commission Expires: w rrd b L fI7 c COMPANY trtAUt PWIC M1111 V 1`41111111114 310 tit 0r1 tum up. UEC 11.19a 3`04%2, a; a u,occe531qW11-q$ flttrll ns. oro. of Tftle insurance. eonnM" J eri eve+ AWLt DO lip -,90 p0 This Instrument Prepared and Return to: Colin M. Cameron 200 NE 4th Avenue Okeechobee, FL 34972 Parcel No.: 3-28-37-35-0120-00230-0050 i 11111111111 Ilill Ilill 11111 ilifi ilil fill FILE HUM 2012009587 OR BK 00720 PG 0158 SHARON ROBERTSON, CLERK OF CIRCUIT COURT OKEECHOBEE COUNTY, FLORIDA RECORDED 09/19/2012 02:04:06 PH AMT 70x000.00 RECORDING FEES $18.501 DEED DOC $490.00 RECORDED BY R Parrish P9s 0168 - 169; (2P9s) THIS WARRANTY DEED, made the X—day of 2012 by HUBERT E. CONNER, JR., a married man, whose post office addres is 7909 Shady Lane, Surry, TX 75158 herein named the Grantor, to JENOVA CONNER HOELSCHER, a married woman, whose post office address is 6412 Highway 441 SE, Okeechobee, FL 34974 hereinafter called the Grantee. WITNESSETH, That the Grantor, for and in consideration of the sum of $ 10.00 and other valuable considerations, receipt whereof is hereby acknowledged, hereby grants, bargains, sells, aliens, remises, releases, conveys and confirms unto the Grantees all that certain land, situate in Okeechobee County, State of Florida, viz: LOTS 5 and 6 OF AVOC� 15th 23, WOODLAND PARK & W 15 FT OF SW 15 AVENUE, LYING T TO SAID LOTS, ACCORDING TO THE PLAT THEREOF RECORDE I� �TT BOOK 2, PAGE 28, PUBLIC RECORDS OF OKEECHOBEE CO �y This is not the homesterr .Pr"i'n or. Subject to all restrictions, imui�' ns covenants running with the title to the property. TOGETHER, with all the tenement s and appurtenances thereto belonging or in anywise appertaining. TO HAVE AND TO HOLD, the same in fee simple forever. AND the grantor hereby covenants with said grantee that the grantor is lawfully seized of said land in fee simple; that the grantor has good right and lawful authority to sell and convey said land, and hereby warrants the title to said land and will defend the same against the lawful claims of all persons whomsoever; and that said land is free of all encumbrances; except taxes accruing subsequent to December 31, 2011. IN WITNESS WHEREOF, the said Grantor has hereunto set his hand and seal the day and year first above written. i ed sealed and livered in a presence of- Wttwss Signature HIJBERT E. CONNER, JR. 7909 Shady Lane Surry, TX 75158 Witness Printed Name Book720/Page168 CFN#2012009687 Page 1 of 2 Jl�• ` 'NIPIC4 Witness Signature r Vjd' t ZA Witness Printed Name STATE OF. ��� f rn m COUNTY OFF BEFORE ME, the undersigned authority, personally appeared HUBERT E. C NNER. ❑ who is personally known to me or ❑ who has produced as identification, and who did / did not take an oath, to me known to be the persons described in and who executed the above and foregoing WARRANTY DEED, and they acknowledged before me that they executed the same. IN WITNESS WHEREOF, I have hereunto set my hand and seal this the 0�z day of August, 2012. ,- JOYCE A CLWWJ 88 My Comm w" Ellin FebrvVy 3.201 4 O rRYYUBL-IC r�—': '2ytt A, ' -- Commission Expires: I hereby certify that I have prepared this instrument from information given to me by the parties hereto. I do naL guarantee either marketability of title or accuracy of description or quantity of land described as I did not examine the title to the property involved. Book720/Page169 CFN#2012009687 Page 2 of 2 This Instrument Prepared and Return to: Colin M. Cameron 200 NE 4th Avenue Okeechobee, FL 34972 Parcel No.: 3-28-37-35-0120-00230-0070 THIS WARRANTY DEED, made the day AVtA 2014 by HUBERT E. CONNER, JR., a married man, whose post office address is 7909 S ady Lane, Surry, TX 75158 herein named the Grantor, to JENOVA CONNER HOELSCHER, a married woman, whose post office address is 6412 Highway 441 SE, Okeechobee, FL 34974 hereinafter called the Grantee. WITNESSETH, That the Grantor, for and in consideration of the sum of $10.00 and other valuable considerations, receipt whereof is hereby acknowledged, hereby grants, bargains, sells, aliens, remises, releases, conveys and confirms unto the Grantee all that certain land, situate in Okeechobee County, State of Florida, viz: LOTS 7 AND 8 OF BLOCK 23, WOODLAND PARK, ACCORDING TO THE PLAT THEREOF RECORDED IN PLAT BOOK 2, PAGE 28, PUBLIC RECORDS OF OKEECHOBEE COUNTY, FLORIDA. Subject to all restrictions, reservations and easements of record. TOGETHER, with all the tenements, hereditaments and appurtenances thereto belonging or in anywise appertaining. TO HAVE AND TO HOLD, the same in fee simple forever. AND the grantor hereby covenants with said grantee that the grantor is lawfully seized of said land in fee simple; that the grantor has good right and lawful authority to sell and convey said land, and hereby warrants the title to said land and will defend the same against the lawful claims of all persons whomsoever; and that said land is free of all encumbrances; except taxes accruing subsequent to December 31, 2012. IN WITNESS WHEREOF, the said Grantor has hereunto set his hand and seal the day and year first above written. Signed, sealed and delivered in the presence of: �0',Jvf Wi ess igna ure -- — F JBBR��E. NNER, JR. 7909 Shady Lane Jlc�'l Me Surry, TX 75158 Witness Printed Name Witness Signature �tj A49 s Witness Printed Name STATE OF TEXA COUNTY OF BEFORE ME, the undersigned authority, personally appeared HUBERT E. CONNER., JR, , who is personally kno me or ❑who has produced as identification, and who di me take an oath, to me known to be the person described in and who executed the above anforegoing Warranty Deed, and he acknowledged before me that he executed the same. IN WITNESS WHEREOF, I have hereunto set my hand and seal this the day of January, 2014. x a 4PHY 1•ll� e ' JENNIFER MURREY My Commission Expires August 10, 2016 dI�.E til �t*Y aJ \ — I v I hereby certify that I have prepared this instrumentfrom information given to me by the parties hereto. I do not guarantee either marketability of title or accuracy of description or quantity of land described as I did not examine the title to the property involved. IN THE CIRCUIT COURT FOR THE NINETEENTH JUDICIAL CIRCUIT IN AND FOR OKEECHOBEE COUNTY, FLORIDA CASE N0. -�a l a ' 0 --o5to IN RE: ESTATE OF: IRENE MARIE CONNER, Deceased, LETTERS OF ADMINISTRATION (single personal representative) TO ALL WHOM IT MAY CONCERN STATE OF R.ORIDA OKEECHOBEE COUNTY THIS IS TO CEgnFY THAT T141S IS A TRUE AND CORRE , 'COPY OF THE RECORDS ON F11.91" TH 0 SHARQfr. ROO - Id, CLERK BY . / . 6i9iiK WHEREAS, IRENE MARIE CONNER, a resident of Okeechobee, Okeechobee County, Florida, died on January 2, 2012, owning assets in the State of Florida, and WHEREAS, JENOVA HOELSCHER has been appointed personal representative of the estate of the decedent and has performed all acts prerequisite to issuance of Letters of Administration in the estate, NOW, THEREFORE, I, the undersigned circuit judge, declare JENOVA HOELSCHER duly qualified under the laws of the State of Florida to act as personal representative of the estate of IRENE MARIE CONNER, deceased, with full power to administer the estate according to law; to ask, demand, sue for, recover and receive the property of the decedent; to pay the debts of the decedent as far as the assets of the estate will permit and the law directs; and to make distribution of the estate according to law. Done and Ordered in Okeechobee, bee County, FL onl�a 11 2012. �-ELIZABET`f f A. METZGER Circuit Judke rn cn C= 7G -I n (=j 3W c r-- (-:) C7 C) C., Ou C m "p Q I�r1 CZ Copy furnished to: -t Colin M. Cameron, Esquire, 200 NE 4' Avenue, Okeechobee, Florida 34972 W —i O.C. T Cn -n rn x. M N -nrn ra M �, t rn —t cn cn .a µ 'kp' '„•F•. -4 M70 ro 'rn ra MGI r -n N A � C•J T �35 T rn In •� 'M N) W m� • r,i 0 j Universal Property and Casualty Insurance Company Homeowners c/o Universal Risk Advisors Declaration Effective '? 1110 W. Commercial Blvd Suite 300 06/12/2013 - _W__ Fort Lauderdale, FL 33309 Toll Free: 800-425-9113 Renewal Policy Claims: 800-218-3206 Service: Contact your Agent Listed Below Policy Number FROM Policy Period TO INSURED BILLED Agent Code 1501-1201-6377 1 06/12/2013 06/12/2014 12:01 AM Standard Time BQ77 Named Insured and Address Agent Name and Address Jenova Hoelsher Berger Insurance Associates, LLC 1815 SW 5th Avenue 800 South Parrott Ave. Okeechobee, FL 34974 Okeechobee, FL 34974 863-467-1090 8637636411 Premium Summary Basic Coverages Attached Endorsements Total Policy Premium Premium Premium Assessments / Surcharges MGA Fees/Policy Fees (Including Assessments & Surcharges) $2,353.00 ($1,489.00) $650.00 $73.78 $1,587.78 Location 001 Townhouse/ Number of Protection Form Construction Year Rowhcuse Families Occupied Class Territory BCEG H03 Masonry 1980 N 1 Y 6 555 99 Dwelling Protective Device Credits: Wind / Hail County Replacement Cost Home Updated Burglar Fire Sprinkler Shutter Exclusion Okeechobee Y Y Y N N N N We will provide the insurance described in this policy in return for the premium and compliance with all applicable provisions of this policy. If we elect to continue this insurance, we will renew this policy if you pay the required renewal premium for each successive policy period subject to our premiums, rules and forms then in effect. You must pay us prior to the end of the current policy period or else this policy will expire. Insurance is provided only with respect to the following coverages for which a limit of liability is specified, subject to all the conditions of this policy. COVERAGES - SECTION I LIMITS PREMIUMS COVERAGES - SECTION II LIMITS PREMIUMS Coverage A Dwelling $273,152 $2,353.00 Coverage -E- Personal Liability $300,000 $18.00 Coverage B Other Structure $27,317 Coverage -F- Medical Payments $3,000 $5.00 �._.... Coverage -C- Personal Property $136,576 Coverage -D- Loss of Use $54,631 NOTE: The portion of your premium for hurricane coverage is $655.97 The portion of your premium for all other coverages is: $931.81 Section 1 coverages subject to a minimum 2.0% - $5,463 hurricane deductible per calendar year. Section 1 coverages subject to $1,000 non-hurricane (non-sinkhole) deductible per loss. DESCRIBED LOCATION - The Described Location covered by this policy is at the above address unless otherwise stated: 1815 SW 5th Ave Okeechobee, FL 34974 THIS POLICY CONTAINS A SEPARATE DEDUCTIBLE FOR HURRICANE LOSSES WHICH MAY RESULT IN HIGH OUT- OF-POCKET EXPENSES TO YOU. ,,,.� EXPENSE'S �._.� �, ... p.�:._ . , ... ,_ "T-0-YOU. Property and Casualty Insurance.. Flood coverage is not provided b Universal Pro a Company and is not part of this policy. Countersignature Date Chief 6perating Officer UPCIC HO Dec 0212 Printed Date: 2/18/2014 4:24:23 PM 1 of 3 Universal Property and Casualty Insurance Company PREMIUMS HO 00 03 04 91 Homeowners 3 Special Form Declaration Effective " c/o Universal Risk Advisors 1110 W. Commercial Blvd Suite 300 06/12!2013 Fort Lauderdale, FL 33309 Renewal Policy Toll Free: 800-425-9113 Claims: 800-218-3206 Service: Contact your Agent Listed Below Policy Number FROM Policy Period TO INSURED BILLED Agent Code 1501-1201-6377 1 06/12/2013 06/12/2014 12:01 AM Standard Time BQ77 Mortgagee / Additional Interest 01 City of Okeechobee 55 SE 3rd Ave Okeechobee, FL 34974 Additional Interest Aaent Name and Address Berger Insurance Associates, LLC 800 South Parrott Ave. Okeechobee, FL 34974 8637636411 Mortgagee/Additional Interest 01 Mortgagee/Additional Interest 02 Mortgagee/Additional Interest 03 Cit\, of Okeechobee 55 SE 3rd Ave Okeechobee, FL. 34974 Policy Forms and Endorsements Applicable to this Policy NUMBER EDITION DESCRIPTION LIMITS PREMIUMS HO 00 03 04 91 Homeowners 3 Special Form $2,353.00 UPCIC 03 33 07 08 Limited Fungi, Wet or Dry Rot, or Bacteria Section I - $10,000/$20,000; Section II - $50,000 UPCIC 23 02 12 Special Provisions - Florida UPCIC 3 01 98 Outline of Your Homeowner Policy UPCIC 25 01 98 (06-07) Hurricane Deductible UPCIC 19 01 98 Windstorm Protective Devices ($1,840.00) UPCIC 16 01 98 Loss Assessment Coverage $1,000 HO 04 96 04 91 No Coverage for Home Day Care Business UPCIC 04 90 04 91 (06-07) Personal Property Replacement Cost $136,576 $352.00 HO 04 48 04 91 Other Structures $27,317 HO 04 16 04 91 Premises Alarm or Fire Protection System ($24.00) Year Built Surcharge $650.00 Personal Liability Increase Endorsement $300,000 $18.00 Medical Payment Increase Endorsement $3,000 $5.00 Emergency Management Preparedness Assistance Trust Fund $2.00 MGA Fee $25.00 Florida Hurricane Catastrophe Fund Emergency Assessment $19.68 Citizens Emergency Assessment $15.14 2012 Florida Insurance Guaranty Association Recoupment $11.96 LAW AND ORDINANCE COVERAGE IS AN IMPORTANT COVERAGE THAT YOU MAY WISH TO PURCHASE. YOU MAY ALSO NEED TO CONSIDER THE PURCHASE OF FLOOD INSURANCE FROM THE NATIONAL FLOOD INSURANCE PROGRAM. WITHOUT THIS COVERAGE, YOU MAY HAVE UNCOVERED LOSSES. PLEASE DISCUSS THESE COVERAGES WITH YOUR INSURANCE AGENT. COINSURANCE CONTRACT: THIS POLICY CONTAINS A CO - PAY PROVISION THAT MAY RESULT IN HIGH OUT-OF- POCKET EXPENSES TO YOU. UPCIC HO Dec 02 12 Printed Date: 2/18/2014 4:24:23 PM 2 of 3 Universal Property and Casualty Insurance Company A111110 & Declaration Effective , c/o Universal Risk Advisors 1110 W. Commercial Blvd Suite 300 06/12/2013 IFW Fort Lauderdale, FL 33309 Renewal Policy Toll Free: 800-425-9113 Claims: 800-218-3206 Service: Contact your Agent Listed Below Policy NumberFROM Policy Period TO INSURED BILLED Agent Code 1501-1201-6377 1 06/12/2013 06/12/2014 12:01 AM Standard Time BQ77 YOUR POLICY PROVIDES COVERAGE FOR A CATASTROPHIC GROUND COVER COLLAPSE THAT RESULTS IN THE PROPERTY BEING CONDEMNED AND UNINHABITABLE. OTHERWISE, YOUR POLICY DOES NOT PROVIDE COVERAGE FOR SINKHOLE LOSSES. YOU MAY PURCHASE ADDITIONAL COVERAGE FOR SINKHOLE LOSSES FOR AN ADDITIONAL PREMIUM. This replaces all previously Issued policy declarations, if any and is subject to all forms and endorsements attached to this policy. UPCIC HO Dec 02 12 Printed Date: 2/18/2014 4:24:23 PM 3 of 3 Notice of Premium Discounts for Hurricane Loss Mitigation *** Important Information *** About Your Personal Residential Insurance Policy Dear Homeowner, Hurricanes have caused tens of billions of dollars in insured damages and predictions of more catastrophic hurricanes making landfall in Florida have triggered increases in insurance premiums to cover potential future losses. Enclosed is information regarding wind loss mitigation that will make your home more resistant to wind and help protect your family during a catastrophic event. In addition to reducing your hurricane wind premium by installing mitigation features, you may also reduce the likelihood of out of pocket expenses, such as your hurricane deductible, you may otherwise incur after a catastrophic event. What factors are considered in establishing my premium? Your location: The closer a home is to the coast, the more vulnerable it is to damage caused by hurricane winds. This makes the hurricane -wind premium higher than for similar homes in other areas of the state. Your policy: Your insurance policy is divided into two premiums: one for damage caused by hurricane force winds (hurricane -wind) and one for all other damage (all perils), such as fire. Your deductible: Under the law, you are allowed to choose a $500, 2%, 5% or 10% deductible, depending on the actual value of your home. The larger your deductible, the lower your hurricane -wind premium. However, if you select a higher deductible your out-of-pocket expenses in the event of a hurricane claim will be higher. Improvements to your home: The state requires insurance companies to offer discounts for protecting your home against damage caused by hurricane winds. Securing your roof so it doesn't blow off and protecting your windows from flying debris are the two most cost effective measures you can take to safeguard your home and reduce your hurricane -wind premium. These discounts apply only to the hurricane -wind portion of your policy. The costs of the improvement projects vary. Homeowners should contact a licensed contractor for an estimate. You can find a Certified Contractor in your area by visiting the Florida Department of Business and Professional Regulation online at www.myfloridalicense.com. Your maximum discount: Discounts are not calculated cumulatively. The total discount is not the sum of the individual discounts. Instead, when one discount is applied, other discounts are reduced until you reach your maximum discount of 88%. How can I take advantage of the discounts? Homeowners will need a qualified inspector such as a general, building, or residential contractor licensed under Section 489.111, Florida Statutes, or a professional engineer licensed under Section 471.015, Florida Statutes, who has passed the appropriate equivalency test of the Building Code training program as required by Section 553.841, Florida Statutes, or a professional architect licensed under Section 481.213, Florida Statutes, or a building code inspector certified under Section 468.607, to inspect the home to identify potential mitigation measures and verify improvements. For a listing of individuals and/or inspection companies meeting these qualifications contact your insurance agent or insurance company. The following is an example of how much you can reduce your insurance premium if you have mitigating features on your home. The example is based on your hurricane -wind premium* of $717.25 which is part of your total annual premium of $1,673.81. Remember, the discounts shown only apply to the hurricane -wind portion of the premium and the discounts for the construction techniques and features listed below are not cumulative. * Wind mitigation credits apply to that portion of your premium that covers the peril of wind, whether or not a hurricane exists. OIR-B1-1655 (Rev.02/10) Adopted by Rule 690-170.0155 Universal Property and Casualty Insurance Company Homeowners c/o Universal Risk Advisors Declaration Effective 1110 W. Commercial Blvd Suite 300 06/12/2013 Fort Lauderdale, FL 33309 Renewal Policy Toll Free: 800-425-9113 Claims: 800-218-3206 Service: Contact your Agent Listed Below Policy Number FROM Policy Period TO INSURED BILLED Agent Code 1501-1201-6377 06/12/2013 06/12/2014 1 12:01 AM Standard Time BQ77 Named Insured and Address Agent Name and Address Jenova Hoelsher Berger Insurance Associates, LLC 1815 SW 5th Avenue 800 South Parrott Ave. Okeechobee, FL 34974 Okeechobee, FL 34974 863-467-1090 8637636411 Premium Summary Basic Coverages Attached Endorsements Total Policy Premium Premium Premium Assessments / Surcharges MGA Fees/Policy Fees (Including Assessments & Surcharges) $2,353.00 ($1,489.00) $650.00 $73.78 $1,587.78 Location 001 Townhouse/ Number of Protection Form Construction Year Rowhouse Families Occupied Class Territory BCEG H03 Masonry 1980 N 1 Y 6 555 99 Dwelling Protective Device Credits: Wind / Hail County Replacement Cost Home Updated Burglar Fire Sprinkler Shutter Exclusion Okeechobee Y Y Y N N N N We will provide the insurance described in this policy. in return for the premium and compliance with all applicable Pe �.. � p provisions of this policy. If we elect to continue this insurance, we will renew this policy if you pay the required renewal premium for each successive policy period subject to our premiums, rules and forms then in effect. You must pay us prior to the end of the current policy period or else this policy will expire. Insurance is provided only with respect to the following coverages for which a limit of liability is specified, subject to all the conditions of this policy. COVERAGES - SECTION I LIMITS PREMIUMS COVERAGES - SECTION II LIMITS PREMIUMS Coverage -A- Dwelling $273,152 $2,353.00 Coverage -E- Personal Liability $300,000 $18.00 Coverage -B- Other Structure $27,317 Coverage -F- Medical Payments $3,000 $5.00 Coverage -C- Personal Property $136,576 Coverage -D g -Loss of Use $54,631 NOTE: The portion of your premium for hurricane coverage is: $655.97 The portion of your premium for all other coverages is: $931.81 Section 1 coverages subject to a minimum 2.0% - $5,463 hurricane deductible per calendar year. Section 1 coverages subject to $1,000 non -hurricane (non -sinkhole) deductible per loss. DESCRIBED LOCATION - The Described Location covered by this policy is at the above address unless otherwise stated: 1815 SW 5th Ave Okeechobee, FL 34974 THIS POLICY CONTAINS A SEPARATE DEDUCTIBLE FOR HURRICANE LOSSES WHICH MAY RESULT IN HIGH OUT- OF-POCKET EXPENSES TO YOU. Flood coverage is not provided by Universal � Property and Casualty Insurance Company and is not part of this policy. Date Chief operating Officer UPCIC HO Dec 02 12 Printed Date: 2/18/2014 4:24:23 PM 1 of 3 1 Universal Property and Casualty Insurance Company Allow c/o Universal Risk Advisors t i Declaration Effective �;,.; 1110 W. Commercial Blvd Suite 300 06/12/2013 we Fort Lauderdale, FL 33309 Renewal Policy Toll Free: 800-425-9113 Claims: 800-218-3206 Service: Contact your Agent Listed Below Policy Number FROM Policy Period TO INSURED BILLED Agent Code 1501-1201-6377 1 06/12/2013 06/12/2014 12:01 AM Standard Time I BQ77 Mortgagee / Additional Interest 01 City of Okeechobee 55 SE 3rd Ave Okeechobee, FL 34974 Mortgagee/Addltiohal Interest 01 City of Okeechobee 51.) SE 3rd Ave Okeechobee, Fl. 34974 Additional Interest Mortgagee/Additional Interest 02 Agent Name and Address Berger Insurance Associates, LLC 800 South Parrott Ave. Okeechobee, FL 34974 8637636411 Mortgagee/Additional Interest 03 Policy Forms and Endorsements Applicable to this Policy NUMBER EDITION DESCRIPTION LIMITS PREMIUMS HO 00 03 04 91 Homeowners 3 Special Form $2,353.00 UPCIC 03 33 07 08 Limited Fungi, Wet or Dry Rot, or Bacteria Section I - $10,000/$20,000; Section II - $50,000 UPCIC 23 02 12 Special Provisions - Florida UPCIC 3 01 98 Outline of Your Homeowner Policy UPCIC 25 01 98 (06-07) Hurricane Deductible UPCIC 19 01 98 Windstorm Protective Devices ($1,840.00) UPCIC 16 01 98 Loss Assessment Coverage $1,000 HO 04 96 04 91 No Coverage for Home Day Care Business UPCIC 04 90 04 91 (06-07) Personal Property Replacement Cost $136,576 $352.00 HO 04 48 04 91 Other Structures $27,317 HO 04 16 04 91 Premises Alarm or Fire Protection System ($24.00) Year Built Surcharge $650.00 Personal Liability Increase Endorsement $300,000 $18.00 Medical Payment Increase Endorsement $3,000 $5.00 Emergency Management Preparedness Assistance Trust Fund $2.00 MGA Fee $25.00 Florida Hurricane Catastrophe Fund Emergency Assessment $19.68 Citizens Emergency Assessment $15.14 2012 Florida Insurance Guaranty Association Recoupment $11.96 LAW AND ORDINANCE COVERAGE IS AN IMPORTANT COVERAGE THAT YOU MAY WISH TO PURCHASE. YOU MAY ALSO NEED TO CONSIDER THE PURCHASE OF FLOOD INSURANCE FROM THE NATIONAL FLOOD INSURANCE PROGRAM. WITHOUT THIS COVERAGE, YOU MAY HAVE UNCOVERED LOSSES. PLEASE DISCUSS THESE COVERAGES WITH YOUR INSURANCE AGENT. COINSURANCE CONTRACT: THIS POLICY CONTAINS A CO - PAY PROVISION THAT MAY RESULT IN HIGH OUT-OF- POCKET EXPENSES TO YOU. UPCIC HO Dec 02 12 Printed Date: 2/18/2014 4:24:23 PM 2 of 3 Universal Property and Casualty Insurance Company Y c/o Universal Risk Advisors if y Declaration Effective J 4 1110 W. Commercial Blvd Suite 300 06/12/2013 Fort Lauderdale, FL 33309 Renewal Policy Toll Free: 800-425-9113 Claims: 800-218-3206 Service: Contact your Agent Listed Below Policy Number FROM Policy Period TO INSURED BILLED Agent Code '' 1501-1201-6377 06/12/2013 06/12/2014 12:01 AM Standard Time BQ77 YOUR POLICY PROVIDES COVERAGE FOR A CATASTROPHIC GROUND COVER COLLAPSE THAT RESULTS IN THE PROPERTY BEING CONDEMNED AND UNINHABITABLE. OTHERWISE, YOUR POLICY DOES NOT PROVIDE COVERAGE FOR SINKHOLE LOSSES. YOU MAY PURCHASE ADDITIONAL COVERAGE FOR SINKHOLE LOSSES FOR AN ADDITIONAL PREMIUM. This replaces all previously Issued policy declarations, if any and Is subject to all forms and endorsements attached to this policy. UPCIC HO Dec 02 12 Printed Date: 2/18/2014 4:24:23 PM 3 of 3