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Blk 13 & 16 SW Add & SW 7th St/Harvey
11111111111111111 1111111111 11111 1111 1111 FILE NUM 2014009126 OR BI',. 751 PG 1 597 SHARON ROBERTSON, CLERK OF CIRCUIT COURT OKEECHOBEE COUNTY, FLORIDA RECORDED 10/07/2014 12:46:39 PM REC :ORDING FEES $13.50 RECORDED BY G Mewbuurn Pss 1597 - 1598; (2 Rss) LICENSE AGREEMENT (Use of Alleyway and Right -of -way) THIS AGREEMENT, BY AND BETWEEN THE CITY OF OKEECHOBEE, FLORIDA, a Florida Municipal corporation (hereinafter "CITY "), and GLENN C. HARVEY, (hereinafter "OWNER(S) "), dated this 4th day of June , 2014. WHEREAS, OWNER(S) hold fee simple title to the following described real property in Okeechobee County, Florida, to wit: Legal Description: LOTS 1 TO 20 OF BLOCK 13, AND LOTS 1 TO 20 OF BLOCK 16, SOUTHWEST ADDITION, ACCORDING TO THE PLAT THEREOF AS RECORDED IN PLAT BOOK 2, PAGE 7, PUBLIC RECORDS OF OKEECHOBEE COUNTY, FLORIDA. WHEREAS, the CITY owns the following platted alleyway(s) and street(s): THAT FIFTEEN FOOT (15') WIDE ALLEYWAY, RUNNING EAST TO WEST LOCATED BETWEEN LOTS 1 TO 10 OF BLOCK 13, AND LOTS 11 TO 20 OF BLOCK 13, ALL WITHIN THE SOUTHWEST ADDITION SUBDIVISION, AS RECORDED IN PLAY BOOK 2, PAGE 7, PUBLIC RECORDS OF OKEECHOBEE COUNTY, FLORIDA. THAT UNIMPROVED PORTION OF SOUTHWEST 7TH STREET, BEING SEVENTY FOOT (70') WIDE, AND LOCATED BETWEEN SOUTHWEST 10TH AND 11TH AVENUES, ALL WITHIN THE SOUTHWEST ADDITION SUBDIVISION, AS RECORDED IN PLAY BOOK 2, PAGE 7, PUBLIC RECORDS OF OKEECHOBEE COUNTY, FLORIDA. THAT FIFTEEN FOOT (15') WIDE ALLEYWAY, RUNNING EAST TO WEST LOCATED BETWEEN LOTS 1 TO 10 OF BLOCK 16, AND LOTS 11 TO 20 OF BLOCK 16, ALL WITHIN THE SOUTHWEST ADDITION SUBDIVISION, AS RECORDED IN PLAY BOOK 2, PAGE 7, PUBLIC RECORDS OF OKEECHOBEE COUNTY, FLORIDA. WHEREAS, the OWNER(S) desire to make certain improvements in the form of fence(s) and gate(s), in order to fence all their property located within Blocks 13 and 16, which would include the alleyways and the right -of -way of Southwest 7th Street. NOW, THEREFORE, in consideration of the mutual promises and covenants set forth herein, the parties agree as follows: 1. The CITY hereby grants this revocable license for use, of the alleyways within Block 13 and 16, and that portion of Southwest 7th Street between 10th and 11th Avenues, with the understanding the OWNER(S) will maintain the alleyways, and 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 /gates, 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 alleyways within Blocks 13 and 15, and the portion of Southwest 7th Street right -of -way, 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 alleyways /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. Page 1 of 2 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 alleyway /right -of -way, obstruct, close or otherwise restrict access to the alleyway /right- of -way for travel thereon by the CITY or the general public, except as otherwise provided in this agreement. a) OWNER(S) understand and agree that gate(s) must be installed at either the East or West end of both alleyways in said Blocks 13 and 16, and across the portion of said Southwest 7th Avenue, in order to allow travel thereon as noted above, and as shown on the site plan Building Permit No. 1406 -117 to be issued by the City of Okeechobee, Florida. 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 of: Witness Signatur Witness Printed Name: Me L.t_sa_ 3a.. I lY 1 C? Witness Signature: Glenn C. Harvey, Property Owner Witness Printed Name: IV\ a i \ca-v j Witness Address: 55 SE ... AVQ ri u.e, N1 eE ► L Witness Address: rJ Ade • aecho .5 ¥ STATE OF FLORIDA II COUNTY OF Ot 'eerie eL The foregoing instrument was acknowledged before me on u n e Y , 20H, by Glenn C. Harvey, who signed in the presence of these witness(es); and who produced:_ as identification, or l/s personally known. MNota ublic Signature ]'�I F I /5c, Nil rc 0 /- Name of Notary (typed, printed or stamped) Commission No. / E $ 2 5 S- (SEAL) IELISA M. JAHNER Ii,9 C^ ?!S (id h eitY "3058 12,2j 7 ACCEPTED FOR THE CITY: David n, Public Works Director Reviewed for Legal Sufficiency: John R. Cook, City Attorney (City Seal) Page 2 of 2 Lane Gamiotea, CMC, City Clerk FLORIDA FARM BUREAU INSURANGf--. P.O. BOX 147030 GAINESVILLE FL 32614-7030 RETURN SERVICE REQUESTED 0227163028-EDS02-DPC163028=001316:001316.1/1 CITY OF OKEECHOBEE EASEMENT OWNED BY 55 SE 3RD AVE OKEECHOBEE FL 34974-2903 RECEIVED MAR 0 6 2018 PRESORTED First -Class Mail U.S. Postage Paid SR N� Pi 3497 ssaJppR ITVWO pue OWEN 13PI000 dTZ '81VIS `AITO SSOJppd u0ijnjTjsuI 1VT3UPUT< :OWUN u0Tjn}TjsuI TUTOUVUTJ 'no/t IDeluOO TTTm aleTOOSSe ssaursnq SONI ue pue 6u,moTTOI ayl alaTdwoo aseaTd `Is00 ou le ATTeotuo.IDaTO su014BOT3TIou OATO38J of siala.id uo>Initlsu> inoA 3T :ATuo suoilnlTlsuT Tel:oueuT} uoU -moTaq ayl �o TIE 9uou6i aseaTd`TenPTAipu> ue a.ie nOA II -sHueq pue satuedwoo 96e6liow se CTuo suo>Initlsul TPTOueuTl of SOTTdde pjeo aqI do OPTS STgj 'noA of suoTleDT}Tlou aoueinsui aptAo.id 01 SONI /tuedwoo aql sasn 30NvunSNI f1vmne NUVJ VaTHOIJ POLICY NO: HO 8639564 HOMEOWNER POLICY POLICY EFFECTIVE DATE: 04/26/2018 POLICY EXPIRATION DATE: 04/26/2019 POLICY RENEWAL EFFECTIVE AS OF 04/26/2018 INSURED: GLENN C HARVEY PROPERTY: 603 SW 11TH AVE OKEECHOBEE COUNTY OKEECHOBEE FL 34974-4047 TOTAL PREMIUM $ 2,315.00 DEDUCTIBLE $ 1,000.00 DWELLING COVERAGE LIMIT $ 300,000 POLICY NO: HO 8639564 • CONTINUED �QEDr'r r 1 a elsod iadaad lnoyllM iaAtl2p ION IPM 901110 lsod pannbaa a6elsod INTERESTED PARTY NOTIFICATION 02/26/2018 INSURER: FLORIDA FARM BUREAU LOAN NO: INTERESTED CITY OF OKEECHOBEE PARTY: EASEMENT OWNED BY 55 SE 3RD AVE OKEECHOBEE FL 34974-2903 AGENCY: 863-763-3101 M CELESTE HARVEY 401 NW 4TH ST OKEECHOBEE FL 34972-2550 ADDITIONAL/EXCLUDED COVERAGES HURRICANE COVERAGE APPLIES 2.00% DED $ 300,000.00 LIMIT WINDSTORM/HAIL COV APPLIES $ 1,000.00 DED $ 300,000.00 LIMIT SINKHOLE COVERAGE APPLIES 10.00% DED $ 300,000.00 LIMIT 9b05-L009b IW `A0 -ll SbOS XO9 Od JOIJ000 U0Tjng1,I}ST0 SONI M." 04/29/2016 11:18 8637631624 Quote26K8.5 /N_F AKVt y FARM BUREAU Florida Farm Bureau General Insurance Homeowners Policy Application 4/26/2016 12:22:17 PM Basic Policy Information Policy # HO 8639564 Cty /Branch /Agt: 047/00/31503 - M CELESTE HARVEY Insured: GLENN C HARVEY Home: (863) 623 -8068 / Work: () - Malling Address: 603 SW 11TH AVE, OKEECHOBEE, FL 34974 Residence Premises Address: 603 SW 11TH AVE, OKEECHOBEE, FL 34974 x4424 P 002 rage 2 o 16 Eff Date: 4/26/2016 Exp Date: 4/26/2017 U Quote #2688578 Account# 091735784530 -00 Member# 1024159 SS# XXX -XX -5469 Premium Attached: $2731.00 I Policy Term Premium: $2731.00 J Payment: Insured's Check 1 Bill: Direct Bill 1 Type: Full Pay Mortgagee, Llenholder, Additional Insured Information Type: Additional Insured Name: CITY OF OKEECHOBEE Loan# Addr: 55 SE 3RD AVE, OKEECHOBEE FL, 34974 Country Squire Mortgagee, Llenholder, Additional Insured Information Rating Information Section: 021 Township: 37S Range: 35E Protection Class: 9 Subdiv: Fire District: OKEECHOBEE Loc County: 47 Territory: 471 FMUN: 706 Homeowner /Auto Discount: N Renovation Year: 2013 PMUN: 706 1000 ET from Hydrant: N Feet from water: N FBC Compliant Roof: N Int for Al: Other, EASEMENT OWNED BY Form: 3 Windstorm Excluded: N Value Up: Y BCEG: 99 Townhouse Units: 0 2001 Compliant: N Roof Shape: Gable Roof Conn: Single Wrap Wind Terrain: B - Urban/Suburban Res: Primary Construct Type: Stucco On Masonry Year Complete: 1974 Replacement Personal Prop: None Screen Sg Ft: 0 Loss Settlement %: 00 # Stories: 1 Mitigation Credit Bypassed: No Roof Cover: Shingle 2nd Water Resist: N WindSpeed:119 Builders Risk: None FH023: No # of Families: 1 FBC Compliant Roof: N Roof Installed: 2005 Roof Deck: 80 8x6 Opening Prot: Class C Prot Applies; Windows Only Wind Borne Debris: No Cov A -- Dwellings; $300000 Cov B • Other Structure: $30000 Cov C - Personal Property: $140000 Coy Loss of Use: $60000 Cov E - Personal Llabtlity; $600000 Cov F - Medical Payment: $5000 Deductible: $1000 Hurricane Deductible: 2% ($6,000) Indorsements Ordinance Or Law Coverage Rejected Premises Alarm: Local Fire or Smoke Alarm Your policy will provide coverage for Catastrophic Ground Cover Collapse resulting in your property being condemned and uninhabitable. You may select Sinkhole Less Coverage for an additional premium. I reject Sinkhole Loss Coverage. X 1 select Sinkhole Loss Coverage. https:// ffblink .com/fbAppPrint/default.aspx ?Quote= 2688578 &func = app &layout =print 4/26/.016 Quote2688578_HARVEY Homeowners Policy Application: HO 8639564 4/26/2016 12:22:17 PM Florida Farm Bureau General Insurance Company Evidence of Residential Property Insurance Homeowners Policy Form: HO 0003 Special Form Policy # HO 8639564 Date of Certificate: 4/26/2016 12:22:17 PM Page 16 of 16 This is evidence that insurance as identified below is in force. This certificate does not amend, extend or alter coverage afforded by the policy listed below. NAMED INSURED AND MAILING ADDRESS: GLENN C HARVEY 603 SW 11TH AVE, OKEECHOBEE, FL 34974 Location of Property: 603 SW 11TH AVE, OKEECHOBEE, FL 34974 Additional Insured Name and Address: Loan# CITY OF OKEECHOBEE 55 SE 3RD AVE, OKEECHOBEE FL, 34974 Cov A- Dwelling:$300000 Cov B -Other Structures:$30000 Cov C- Personal Property:$150000 Cov D -Loss of Use:$60000 Cov E- Personal Liabtllty:$500000 Cov F- Medical Payment to Others:$5000 Hurricane Deductible:2% ($6,000) All Other Perils Deductible:$1000 ANNUAL PREMIUM: $2731.00 EFFECTIVE DATE: 4/26/2016 to 4/26/2017 PAID IN FULL AUTHORIZED AGENT'S NAME AND MAILING ADDRESS: M CELESTE HARVEY 401 NW 4TH ST OKEECHOBEE,FL 34972 PHONE: (863)763 -3101 FAX: (863)763 -1624 This form Is for proof of Insurance only. Policy Declarations supercede anything listed herein. Cancellation Provisions: This policy is subject to the premiums, forms and rules in effect for each policy period. If this policy is terminated, we will give the Mortgagees written notice in compliance with the policy provisions or as required by law. This certificate will expire at 12:01 AM Standard Time, 15 days from the date of )gist certificate a indict d above. Authorized Agent's Signature,__ i Agent # 1_,>:`County`q Branch: eForm 93 -7 -4410 (Ed. 07/04) https:// ffblink. com /fbAppPrint /default.aspx ?Quote= 2688578 &func = app &layout =print 4/26/2016 CAPITOLP.O. BOX 15339 , ,FrPOLICY PERIOD To POLICY NUMBER v TALLAHASSEE, FL 32317 -5339 Preferred Insurance Company, Inc. CPH 2108799 01 55 04/10/2016 04/10/2017 12 01 A.M. Standard Time at the described location For Customer Service Call ;1- 800 -734 -4749 For Claims Call 1- 888 - 388 -2742 RENEWAL DECLARATION Effective: 04/10/2016 Date Issued: 02/25/2016 INSURED: AGENT: 0700068 ` ' GLENN HARVEY LAWRENCE INSURANCE AG#I\C 603 SW 11TH AVE RONNIE LAWRENCE OKEECHOBEE FL 34974 PO BOX 549 OKEECHOBEE. FL 34973 1- -- °_.' Telephone: 863 - 697 -3709 Telephone: 863 - 467 -0600 71 The residence premises covered by this policy is located at the above insured address unless otherwis ed below: 603 SW 11TH AVE OKEECHOBEE FL 34974 IF PAYMENT IS NOT RECEIVED ON OR BEFORE THE POLICY RENEWAL EFFECTIVE DA THIS POLICY WILL NOT BE IN FORCE. Coverage is provided where premium and limit of liability is shown. Flood coverage is not provided by CAPITOL PREFERRED and is not a part of this policy. SECTION I COVERAGE A. DWELLING B. OTHER STRUCTURES C. PERSONAL PROPERTY D. LOSS OF USE SECTION II COVERAGE E. PERSONAL LIABILITY F. MEDICAL PAYMENTS OPTIONAL COVERAGES Replacement Cost Contents LIMITED FUNGI,ROT BACTERIA WATER BACK -UP & SUMP OVERFLOW LIMIT OF LIABILITY $285,000.00 $28,500.00 $142,500.00 $57,000.00 $300,000.00 $1,000.00 $10,000/$20,000 $5,000.00/$250.00 Deductible TOTAL POLICY PREMIUM INCLUDING ASSESSMENTS AND ALL SURCHARGES: SEE REVERSE SIDE PREMIUM CHANGE DUE TO RATE CHANGE PREMIUM CHANGE DUE TO COVERAGE CHANGE PLEASE CONTACT YOUR AGENT IF THERE ARE ANY QUESTIONS PERTAINING TO YOUR POLICY. PREMIUMS $2,727.00 INCLUDED INCLUDED INCLUDED $18.00 INCLUDED INCLUDED INCLUDED $100.00 $2,873.00 191.00 C.00 FORMS AND ENDORSEMENTS CPH FL AL (10/03) CPHFLCGCC (04/09) CPHFLMC3 (01/03) CPHFLO599 (12/13) Continued on Forms Schedule CPH FL H3 (08/02) CPHFLDB (12/03) CPHFLOH (04/09) CPICH0300 (05/98) COUNTERSIGNED DATE 02/25/2016 BY ADDITIONAL INTERESTS oria ADDITIONAL INSURED CITY OF OKEECHOBEE 55 SE 3RD AVE OKEECHOBEE FL 34974 CPH FL DEC 09/02 ADD'L INSURED'S COPY 0000000053 TOTAL WIND MITIGATION CREDITS ROOF COVER NON FBC EQUIVALENT ROOF DECK 8d @ 6/12 ROOF SHAPE OTHER ROOF SHAPE - GABLE /FLAT ROOF WALL SINGLE WRAPS OPEN PROTECTION NONE SWR NO SWR TERRAIN TERRAIN B 2% DED FBC WIND SPEED MPH N/A WIND SPEED OF DESIGN N/A INTERNAL PRESSURE N/A WBDR N/A FRPC -16 (09/95) HO -0496 (10/00) PIC -13 (08/97) FRPC -24 (07/97) OIRB11655 (02/10) Policy Number Policy Period From To CPH 2108799 01 55 04/10/2016 04/10/2017 1 2:01 A.M. Standard Time at the described location FORMS SCHEDULE (continued from page 1) HO 0355 (01/06) ` OIRB11670 (01/06) HO -0109 (12/12) PIC 08 (02/98) HO -0490 (04/91) PIC 09 (02/98) 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. 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 HAVEI UNCOVERED LOSSES. PLEASE DISCUSS THESE COVERAGES WITH YOUR INSURANCE AGENT. CPIC FL FS 09/02 ADD'L INSURED'S COPY Capitol Preferred Insurance Company, Inc. P.O. Box 15339 Tallahassee, FL 32317 -5339 0000000012 CITY OF OKEECHOBEE 55 SE 3RD AVE OKEECHOBEE FL 34974 CPH 2108799 01 0000000051 HOMEOWNERS DECLARATION C A I 1 OL POLICY NUMBER From PERIOD Preferred Insurance Company, Inc. CPH 2108799 01 55 04/10/2016 04/10/2017 12 01 A.M. Standard Time at the described location For Customer Service Call 1 -800- 734 -4749 For Claims Call 1- 888 -388- 2742 RENEWAL DECLARATION Effective: 04/10/2016 Date Issued: 02/25/2016 INSURED: AGENT: 0700068 GLENN HARVEY LAWRENCE INSURANCE AGENCY INC 603 SW 11TH AVE RONNIE LAWRENCE OKEECHOBEE FL 34974 PO BOX 549 OKEECHOBEE, FL 34973 Telephone: 863 - 697 -3709 Telephone: 863 - 467 -0600 The residence premises covered by this policy is located at the above insured address unless otherwise stated below: 603 SW 11TH AVE OKEECHOBEE FL 34974 All other perils deductible: $ 1,000.00 Hurricane Deductible: $ 5,700.00 Premium: $ 1,093.00 Note: The portion of your premium for Hurricane Coverage is: SECTION I, SECTION II AND OPTIONAL PREMIUMS EMERGENCY MANAGEMENT TRUST FUND SURCHARGE MGA POLICY FEE $ 1,652.00 $ 2,845.00 $ 2.00 $ 25.00 2012 FLORIDA INSURANCE GUARANTY FUND ASSESSMENT $ 1.00 TOTAL POLICY PREMIUM INCLUDING ASSESSMENTS AND ALL SURCHARGES FORM TYPE CONSTRUCT TYPE TERRITORY USE CODE COUNTY CODE PROT DEV /SPRINKLER REPLACEMENT COST HO -3 M 555 P 047 N Y YEAR BUILT CONSTRUCT SUPERIOR PROTECTION CLASS HOME UPDATED PROT DEVICE /BURGLAR EXCLUDE CONTENTS OCCUPANCY CODE 1974 N 03 N N N OWNER $ 2,873.00 TOWN /ROW HOUSE NUMBER OF FAMILIES PRIOR DEC S/C MUNICIPAL CODE PROT DEVICE /FIRE WIND /HAIL EXCLUSION N 1 706 N N A premium adjustment of $0.00 is included to reflect the building code grade for your area. Adjustments range from a 4.8% surcharge to a 46.1% credit. THIS POLICY CONTAINS A SEPARATE DEDUCTIBLE FOR HURRICANE LOSSES WHICH MAY RESULT IN HIGH OUT -OF- POCKET EXPENSES TO YOU. CPH FL DEC 09/02 ADD'L INSURED'S COPY 0000000054 CAPITOL P.O. BOX 15339 Preferred Insurance Company, Inc. TALLAHASSEE, FL 32317-5339 HOMEOWNERS DECLARATION POLICY;:NUMBER PAi.tCY t�EtfitO:C� From To CPH 2108799 01 55 04/10/2016 04/10/2017 12:01 A.M. Standard Time at the described location For..Customer Ser 4ce CaII....t =800= :734=4749 :::For Cl:aims:;Calt. 1: =888 - 388 2742 i RENEWAL DECLARATION tNS:URED: .. GLENN HARVEY 603 SW 11TH AVE OKEECHOBEE FL 34974 Telephone: 863 - 697 -3709 Effective: 04/10/2016 Date Issued: 02/25/2016 AGENT: 0700068 i:: LAWRENCE INSURANCE AG RONNIE LAWRENCE PO BOX 549 OKEECHOBEE, FL 34973 Telephone: 863 - 467 -060q The residence premises covered by this policy is located at the above insured address unless otherwis 603 SW 11TH AVE OKEECHOBEE FL 34974 ed below: IF PAYMENT IS NOT RECEIVED ON OR BEFORE THE POLICY RENEWAL EFFECTIVE DA THIS POLICY WILL NOT BE IN FORCE. Coverage is provided where premium and limit of liability is shown. Flood coverage is not provided by CAPITOL PREFERRED and is not a part of this policy. SECTION I COVERAGE LIMIT OF LIABILITY A. DWELLING B. OTHER STRUCTURES C. PERSONAL PROPERTY D. LOSS OF USE SECTION II COVERAGE E. PERSONAL LIABILITY F. MEDICAL PAYMENTS OPTIONAL COVERAGES Replacement Cost Contents LIMITED FUNGI,ROT BACTERIA WATER BACK -UP & SUMP OVERFLOW $285,000.00 $28,500.00 $142,500.00 $57,000.00 $300,000.00 $1,000.00 $1o,000 /$2o,000 $5,000.00/$250.00 Deductible TOTAL POLICY PREMIUM INCLUDING ASSESSMENTS AND ALL SURCHARGES: SEE REVERSE SIDE PREMIUM CHANGE DUE TO RATE CHANGE PREMIUM CHANGE DUE TO COVERAGE CHANGE PLEASE CONTACT YOUR AGENT IF THERE ARE ANY QUESTIONS PERTAINING TO YOUR POLICY. PREMIUMS $2,727.00 INCLUDED INCLUDED INCLUDED $18.00 INCLUDED INCLUDED INCLUDED $100.00 $2,873.00 191.00 0.00 FORMS AND EN ORSEIVIEN S CPH FL AL (10/03) CPHFLCGCC (04/09) CPHFLMC3 (01/03) CPHFLO599 (12/13) Continued on Forms Schedule CPH FL H3 (08/02) CPHFLDB (12/03) CPHFLOH (04/09) CPICHO300 (05/98) COUNTERSIGNED DATE 02/25/2016 BY ADDITIONAL INSURED CITY OF OKEECHOBEE 55 SE 3RD AVE OKEECHOBEE FL 34974 CPH FL DEC 09/02 ADD'L INSURED'S COPY 0000000053 CAPITOL Preferred Insurance Company, Inc. HOMEOWNERS DECLARATION POLICY:::: NUMBER - POLICY: PERIQD l=ro:m •Tn :::: CPH 2108799 01 55 04/10/2016 04/10/2017 12:01 A.M. Standard Time at the described location For:::trustvmer Serv(ce Sr:att 1 80.53 734 4149 ::; Eor C.ta�rrrs` C. all 1: -888 3:8:8 2742 . RENEWAL DECLARATION Effective: 04/10/2016 Date Issued: 02/25/2016 IINS :tRED: AGENT :: 0700068 GLENN HARVEY 603 SW 11TH AVE OKEECHOBEE FL 34974 Telephone: 863 - 697 -3709 LAWRENCE INSURANCE AGENCY INC RONNIE LAWRENCE PO BOX 549 OKEECHOBEE, FL 34973 Telephone: 863 - 467 -0600 The residence premises covered by this policy is located at the above insured address unless otherwise stated below: 603 SW 11TH AVE OKEECHOBEE FL 34974 Note: All other perils deductible: $ 1,000.00 Premium: $ 1,093.00 Hurricane Deductible: $ 5,700.00 The portion of your premium for Hurricane Coverage is: SECTION I, SECTION II AND OPTIONAL PREMIUMS EMERGENCY MANAGEMENT TRUST FUND SURCHARGE MGA POLICY FEE 2012 FLORIDA INSURANCE GUARANTY FUND ASSESSMENT TOTAL POLICY PREMIUM INCLUDING ASSESSMENTS AND ALL SURCHARGES FORM TYPE CONSTRUCT TYPE TERRITORY USE CODE COUNTY CODE PROT DEV /SPRINKLER REPLACEMENT COST HO -3 M 555 P 047 N Y YEAR BUILT CONSTRUCT SUPERIOR PROTECTION CLASS HOME UPDATED PROT DEVICE /BURGLAR EXCLUDE CONTENTS OCCUPANCY CODE 1974 N 03 N N N OWNER $ 1,652.00 $ 2,845.00 $ 2.00 $ 25.00 $ 1.00 $ 2,873.00 TOWN /ROW HOUSE NUMBER OF FAMILIES PRIOR DEC S/C MUNICIPAL CODE PROT DEVICE /FIRE WIND /HAIL EXCLUSION N 1 706 N N A premium adjustment of $0.00 is included to reflect the building code grade for your area. Adjustments range from a 4.8% surcharge to a 46.1% credit. THIS POLICY CONTAINS A SEPARATE DEDUCTIBLE FOR HURRICANE LOSSES WHICH MAY RESULT IN HIGH OUT -OF- POCKET EXPENSES TO YOU. CPH FL DEC 09/02 ADD'L INSURED'S COPY 0000000054 TOTAL WIND MITIGATION CREDITS ROOF COVER NON FBC EQUIVALENT ROOF DECK 8d @ 6/12 ROOF SHAPE OTHER ROOF SHAPE - GABLE /FLAT ROOF WALL SINGLE WRAPS OPEN PROTECTION NONE SWR NO SWR TERRAIN TERRAIN B 2% DED FBC WIND SPEED MPH N/A WIND SPEED OF DESIGN N/A INTERNAL PRESSURE N/A WBDR N/A FRPC -16 (09/95) HO -0496 (10/00) PIC -13 (08/97) FRPC -24 (07/97) OIRB11655 (02/10) .................................................................................................... ............................... .Policy Number:: : >P}oiicy PrFOd• from To CPH 2108799 01 55 04/10/2016 04/10/2017 12:01 A.M. Standard Time at the described location FORMS SCHEDULE (continued from page 1) HO 0355 (01/06) OIRB11670 (01/06) HO -0109 (12/12) PIC 08 (02/98) HO -0490 (04/91) PIC 09 (02/98) 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. 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 HAVEI UNCOVERED LOSSES. PLEASE DISCUSS THESE COVERAGES WITH YOUR INSURANCE AGENT. CPIC FL FS 09/02 ADD'L INSURED'S COPY Capitol Preferred Insurance Company, Inc. P.O. Box 15339 Tallahassee, FL 32317 -5339 0000000012 CITY OF OKEECHOBEE 55 SE 3RD AVE OKEECHOBEE FL 34974 CPH 2108799 01 0000000051 CAPITOL P.O. BOX 15339 TALLAHASSEE, FL 32317 -5339 Preferred Insurance Company, Inc. F:or :CUStor►ier Servlge Call:l 80.0 =:734 -4:749 For :Cl:aims;Call 1. 888 - 388 2742 : HOMEOWNERS DECLARATION POLICY NUMBER POLICY PERIOD From To CPH 2108799 00 55 04/10/2015 04/10/2016 12:01 A.M. Standard Time at the described location NEW DECLARATION Effective: 04/10/2015 Date Issued: 04/23/2015 INSURED: AGENT: 0700068 GLENN HARVEY 603 SW 11TH AVE OKEECHOBEE FL 34974 Telephone: 863 -697 -3709 LAWRENCE INSURANCE AGENCY INC RONNIE LAWRENCE PO BOX 549 OKEECHOBEE, FL 34973 -0549 Telephone: 863 - 467 -0600 The residence premises covered by this policy is located at the above insured address unless otherwise stated below: 603 SW 11TH AVE OKEECHOBEE FL 34974 Coverage is provided where premium and limit of liability is shown. Flood coverage is not provided by CAPITOL PREFERRED and is not a part of this policy. SECTION I COVERAGE LIMIT OF LIABILITY A. DWELLING B. OTHER STRUCTURES C. PERSONAL PROPERTY D. LOSS OF USE SECTION II COVERAGE E. PERSONAL LIABILITY F. MEDICAL PAYMENTS OPTIONAL COVERAGES Replacement Cost Contents LIMITED FUNGI,MOT BACTERIA WATER BACK -UP & SUMP OVERFLOW $285,000.00 $28,500.00 $142,500.00 $57,000.00 $300,000.00 $1,000.00 $10,000/$20,000 $5,000.00/$250.00 Deductible TOTAL POLICY PREMIUM INCLUDING ASSESSMENTS AND ALL SURCHARGES: SEE REVERSE SIDE PLEASE CONTACT YOUR AGENT IF THERE ARE ANY QUESTIONS PERTAINING TO YOUR POLICY. PREMIUMS $2,536.00 INCLUDED INCLUDED INCLUDED $18.00 INCLUDED INCLUDED INCLUDED $100.00 $2,711.00 =FORMS AND E :N DORSEMENTS CPH FL AL (10/03) * CPHFLCGCC (04/09) .CPHFLMC3 (01/03) (12/13) Continued on Forms Schedule *CPH FL H3 (08/02) *CPHFLDB (12/03) *CPHFLOH (04/09) * CPICHO300 (05/98) COUNTERSIGNED DATE 04/23/2015 BY :: :ADDI: lONAL::INTE RESTS: ADDITIONAL INSUREID CITY OF OKEECHOBEE 55 SE 3RD AVE OKEECHOBEE FL 34974 CPH FL DEC 09/02 ADD'L INSURED'S COPY 0000000149 CAPITOL Preferred Insurance Company, Inc. HOMEOWNERS DECLARATION POLICY NUMBER POLICY :PERIOD from To CPH 2108799 00 55 04/10/2015 04/10/2016 12:01 A.M. Standard Time at the described location For 'for Customer Service Call 1- 800 - 734-4749 For Claims Call 1- 888 -388- 2742 NEW DECLARATION Effective: 04/10/2015 Date Issued: 04/23/2015 .INSURED_ i.:. AGENT: 0700068 GLENN HARVEY 603 SW 11TH AVE OKEECHOBEE FL 34974 Telephone: 863 - 697 -3709 LAWRENCE INSURANCE AGENCY INC RONNIE LAWRENCE PO BOX 549 OKEECHOBEE, FL 34973 -0549 Telephone: 863 - 467 -0600 The residence premises covered by this policy is located at the above insured address unless otherwise stated below: 603 SW 11TH AVE OKEECHOBEE FL 34974 Note: All other perils deductible: $ 1,000.00 Premium: $ 1,016.00 Hurricane Deductible: $ 5,700.00 The portion of your premium for Hurricane Coverage is: SECTION I, SECTION II AND OPTIONAL PREMIUMS EMERGENCY MANAGEMENT TRUST FUND SURCHARGE MGA POLICY FEE 2012 FLORIDA INSURANCE GUARANTY FUND ASSESSMENT CITIZENS EMERGENCY HRA ASSESSMENT TOTAL POLICY PREMIUM INCLUDING ASSESSMENTS AND ALL SURCHARGES FORM TYPE CONSTRUCT TYPE TERRITORY USE CODE COUNTY CODE PROT DEV /SPRINKLER REPLACEMENT COST HO -3 YEAR BUILT M CONSTRUCT SUPERIOR 555 PROTECTION CLASS P HOME UPDATED 047 PROT DEVICE /BURGLAR N EXCLUDE CONTENTS Y OCCUPANCY CODE 1974 N 03 N N N OWNER $ 1,538.00 $ 2,654.00 $ 2.00 $ 25.00 $ 3.00 $ 27.00 $ 2,711.00 TOWN /ROW HOUSE NUMBER OF FAMILIES PRIOR DEC S/C MUNICIPAL CODE PROT DEVICE /FIRE WIND /HAIL EXCLUSION THIS POLICY CONTAINS A SEPARATE DEDUCTIBLE FOR HURRICANE LOSSES WHICH MAY RESULT IN HIGH OUT -OF- POCKET EXPENSES TO YOU. CPH FL DEC 09/02 ADD'L INSURED'S COPY N 1 N 999 N N 0000000150 PREMIUM FINANCE AGREEMENT AND DISCLOSURE STATEMENT Atlas Premium Finance P.O. Box 100129, Fort Lauderdale FL 33310 Fax this completed Agreement to: (954) 598 -7292 Phone: (800 425 -9113 QUOTE #: 0129151119992 INSURED: Name and Address (as Stated in Policy) PRODUCER: Name and Place of Business GLENN HARVEY 603 SW 11TH AVE Okeechobee, FL 34974 M &M Insuror's of Orlando 670 N Orlando Ave #1004A Maitland, FL 32751 (407) 629-1620 AGENT NO # : 9J83 In consideration of the premium payments to be made by Atlas Premium Finance Company (hereinafter Atlas) to the listed insurance companies, the named insured promises to pay to the order of Atlas, the Total of payments,subject to the provisions hereinafter set forth. TOTAL PREMIUMS DOWN PAYMENT Unpaid Premium Balance Documentary Stamp Chg * *ANNUAL PERCENTAGE RATE ** The cost of your credit at a yearly rate * *FINANCE CHARGE ** The dollar amount the credit will cost you Amount Financed The amount of credit provided to you or on your behalf Total of Payments Amount you have paid after you have made all scheduled payments $2,679.56 $535.91 $2,143.65 $7.70 23.23 $213.60 $2,151.35 $2,364.95 Total Sales Price The total cost of your credit including your down payment Your Payment Schedule Will Be: NUMBER OF PAYMENTS AMOUNT PAYMENT When Payments Are Due Monthly starting 4/20/2015 and continuing on the same day of each succeeding month until paid in full. $2,900.86 9 $262.77 SECURITY You are giving a security interest in the policy(ies) listed below LATE CHARGE : See reverse side, item number (3) three. PREPAYMENT If you pay off early, you may be entitled to a refund of part of the finance charge. SCHEDULE OF POLICIES POLICY PREFIX AND NUMBER EFFECTIVE DATE OF POLICY OR ANNUAL INSTALLMENT (1) FULL NAME OF INSURANCE COMPANY AND BRANCH OFFICE (2) NAME AND ADDRESS OF GENERAL AGENT TO WHICH POLICY PREMIUMS PAID TYPE OF COVERAGE POLICIES SUBJECT TO AUDIT YES or NO POLICY TERMS IN MONTHS PREMIUM AMOUNT 1504- 1400 -2103 03120/2015 Universal Property and Casualty 1110 West Commercial Boulevard Fort Lauderdale FL 33309 Homeowners No 12 Ref F &T NonRef F &T $2,625.00 $0.00 $54.56 NOTE: NON - PAYMENT MAY RESULT IN CANCELLATION OF ABOVE POLICIES. Florida documentary stamp tax required by law in the amount indicated above has been paid or will be paid directly to the Department of Revenue. Certificate of Registration #16-8013914078-6 TOTAL PREMIUM I $2,679.56 NOTICE: 1. DO NOT SIGN THIS AGREEMENT BEFORE YOU READ IT OR IF IT CONTAINS ANY BLANK SPACE. 2. YOU ARE ENTITLED TO A COMPLETELY FILLED -IN COPY OF THIS AGREEMENT. 3. UNDER THE LAW, YOU HAVE THE RIGHT TO PAY OFF IN ADVANCE THE FULL AMOUNT DU AND UNDERCERTAIN CONDITIONS TO OBTAIN A PARTIAL REFUND OF THE FINANCE CHARGE. THE UNDERSIGNED EXECUTED THIS LOAN AGREEMENT AND RECEIVED A COPY THEREOF THIS DAY OF Policy will be cancelled for Non-Payment. SIGNATURE OF INSURED (If Corporation, Title of Officer Signing) X AGENT CERTIFICATION I X The undersigned hereby certifies that all policies listed above hereof have been issued and delivered, and that the down payment as shown in the contract has been paid by or on behalf of the Insured, and that all policies listed therein were issued by this agency. The undersigned warrants that the above contract evidences a bona fide and legal transaction; that the Insured is of legal age and has capacity to contract, that the signature is genuine and that he has delivered a copy of this contract to the Insured. Upon termination of this Agreement, or cancellation of any scheduled policies the undersigned agrees to pay the unearned commissions to Atlas provided the undersigned is not obligated to pay the same to the scheduled insurance companies to their agents. X X PRINT NAME AND ADDRESS OF AGENT OR BROKER OF INSURANCE POLICY(IES) SIGNATURE OF BROKER OR AGENT NOTICE: SEE REVERSE SIDE FOR IMPORTANT INFORMATION ACG THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must bo endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder In lieu of such endorsement(s). CERTIFICATE OF LIABILITY INSURANCE DATE (MM/OD/MY) 09/15/2014 PRODUCER HESTER INSURANCE ASSOC LLC 204 NE 3RD AVE OKEECHOBEE, FL 34974 INSURED GLEN HARVEY 603 SW 11TH AVE OKEEHCOBEE FL 34974 NAME. AACT KIM MOUTSCHKA PHONE (A/C, No, Ext): 863 - 467 -0933 E -MAIL ADDRESS: kim@myhesterins.com_ PRODUCER CUSTOMER ID M; INSURER(S) AFFORDING COVERAGE NAIC INSURER A: UNIVERSAL PROEPRTY & CAS FAX (Arc, No). 863- 763 -2473 INSURER B : INSURER C INSURER 0: INSURER E : INSURER F : BER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE -ADOL`<SUBR` . POLICY EFF ; POUCY EXP LIMITS LTR ' INSR € WVD i POLICY NUMBER (MMIDD/YYYY) ' (MMID0IYYYYI . ':. GENERAL LIABILITY ! COMMERCIAL GENERAL LIABILITY '—"'. CLAIMS -MADE : OCCUR ! , GEN'L AGGREGATE LIMIT .APPLIES PER POLICY . PRO ' LOC : i ' jEcT EACH OCCURRENCE 5 DAMAGE TORENTED PREMISES (Ea occurrence) 5 MED EXP (Any one person) $ PERSONAL E. ADV INJURY S GENERAL AGGREGATE S PRODUCTS - COMP /OP AGG I S S AUTOMOBILE LIABILITY I ANY AUTO I -- -,., j ALL OWNED AUTOS . .. SCHEDULED AUTOS t HIRED AUTOS NON -OWNED AUTOS COMBINED SINGLE LIMIT 1E0 accdent) .... .._ ._ ... _. BODILY INJURY (Per person) _. __. _..., BODILY INJURY (Per acooenI) ..... ._ ... ....._.. PROPERTY DAMAGE (Per accadent). S ... _... 5 .... _.. _... S _.. S S 5 UMBRELLA LIAB '. OCCUR EXCESS LIAR CLAIMS-MADE � ...DEDUCTIBLE ..... . RETENTION $ i EACH OCCURRENCE E AGGREGATE $ S $ _. 5 WORKERS COMPENSATION AND , �, AND EMPLOYERS' LIABILITY Y 1 N ! ANY PROPRIETORIPARTNERIEXECUTIVE OFFICERMEMBER EXCLUDED? 1 N / A (Mandatory In NH) II yes describe under SPP IAi PROVISIONS h rinva : WC STATU- OTH- TORY LIMITS . ER r L EACH ACCIDENT - $ _.... __.. _ E L DISEASE - EA EMPLOYEE. $ 5 L DISEASE - POLICY LIMIT S A HOME LIABILITY I X `) 1504- 1400 -2103 1 03/20/2014 1 03/20/2015 ' 300,000 DESCRIPTION OF OPERATIONS 1 LOCATIONS 1 VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) CERTIFICATE HOLDER CANCELLATION CITY OF OKEEHCOBEE 55 SE 3RD AVE OKEECHOBEE FL 34974 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION GATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED ACORD 25 (2009/09) SENTATIVE ©1988- 2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD SHARON ROBERTSON COURT CLERK OF CIRCUIT COK N.W. LORIDA`_ 312 N. W . 3 COUNTY, TREET, SUITE 155 O OEECHOBEE, FL 34972 863.763.2131 REF: DATE:10 /7/2014 TIME:12:46:39 PM RECEIPT: 2014008427 CITY OF OKEECHOBEE ACCOUNT #: 0 ITEM - 01 AGR RECD: 10/7/2014 12 :46:39 PM 2014009126 BK /P0 0 751/1597 CITY OF OKEECHOBEE FLORIDA HARVEY GLENN Fees Recording 18.50 Subtotal $18.50 TOTAL DUE $20.00 PAID TOTAL $20.00 PAID CASH x$1.50) CASH RETURNED ___ -($1.50) REC BY G MEWBOURN DEPUTY CLERK fil.us www.clerk.co•okeechobee. 18.50 D SearchResults \ 5Q \ \ \A i — 1423( 0_75 Okeechobee County Property O,at n Appraiser Wsst_ ja 2013 Certified Values updated: 5/1/2014 UJ tO■1041-4\ Parcel: 3- 21- 37 -35- 0170 - 00160 -0010 Page 1 of 2 « Next Lower Parcel I Next Higher Parcel » Owner & Property Info Parcel List Generator 2013 TRIM (pdf) Owner's Name HARVEY GLENN C Site Address SW 7TH ST, OKEECHOBEE Mailing Address 425 SW PARK ST OKEECHOBEE, FL 34974 Description SOUTHWEST ADDITION LOTS 1 TO 20 INC BLOCK 16 NOTE: This description is not to be used as the Legal Description for this parcel in any legal transaction. Land Area 2.851 ACRES S /T /R 21-37- 35 Neighborhood 113653.00 Tax District 50 DOR Use Code VACANT (000000) Market Area 40 The DOR Use Code shown here is a Dept. of Revenue code. Please contact the Okeechobee County Planning & Development office at 863- 763 -5548 for specific zoning information. Property & Assessment Values Mkt Land Value cnt: (2) $33,083.00 Ag Land Value cnt: (0) $0.00 Building Value cnt: (0) $0.00 XFOB Value cnt: (0) $0.00 Total Appraised Value $33,083.00 Sales History Retrieve Tax Record Property Card Interactive GIS Map Print Search Result: 25 of « Prev 41 Next » GIS Aerial 2013 Certified Values Just Value $33,083.00 Class Value $0.00 Assessed Value $33,083.00 Exempt Value $o.00 Total Taxable Value $33,083.00 Show Similar Sales within 1/2 mile Fill out Sales Questionnaire Sale Date Book/Page Inst. Type Sale VImp Sale Qual Sale RCode (Code List) Sale Price 6/14/2013 731/1763 WD I Q $130,000.00 http://www.okeechobeepa.com/GIS/D_SearchResults.asp 5/5/2014 HO 8639564 CITY OF OKEECHOBEE EASEMENT OWNED BY 55 SE 3RD AVE OKEECHOBEE FL 34974-2903 REoC3 w PO Box 147032 Gainesville, FL 32614-7032 ACCOUNT NUMBER 09173578453000 CANCELLATION NOTICE This is your notice the following policies have EXPIRED or CANCELED due to non- payment of premium. We will continue to protect your interest until 12:01 AM Standard Time, at your mailing address shown, on the date shown below. THIS IS THE ONLY NOTICE YOU WILL RECEIVE. HO 8639564 GLENN C HARVEY AGENT: TIMOTHY M CRAIG (863) 763-3101 WILL CANCEL 09/10/2019 Florida Farm Bureau Casualty Insurance Co. • Florida Farm Bureau General Insurance Co. 00000