Hulsey - Sold Prop. to Gene FulfordFebruary 26, 1981
LETTER OF UNDERSTANDING
To: City of Okeechobee
From: Mr. and Mrs. William Hulsey
Subject: Agreement for use of seven and one half foot of alley right of way
We understand the City Council of Okeechobee in regular session has approved
the use of the north seven and one half feet of a fifteen foot alley right of
way lying to the rear of our residence. The legal description of our property
is: Lots 2, 3, and 4, Block 213, City of Okeechobee.
It is our understanding we may erect a fence along this seven and a half foot
line with the understanding we will maintain the property and should it ever
become necessary to remove the fence in order to allow either the installation,
or maintenance of water, sewer, or other utility lines or any other type of
installation or construction, the fence is to be removed by us at our expense
within thirty days of being notified by the city in writing.
We also agree to contact our insurance company and request a rider be added
to our insurance policy with a certificate furnished to the city showing the
seven and a half foot right of way to be fenced in by us insures the city
against any liability arising out of alleged injuries or other activities
which may occur within the seven and a half foot right of way.
Accepted for the City:
City Clerk
Myrtl
William Huts
Mayor
State Farm Florida Insurance Company
7401 Cypress Gardens Blvd.
Winter Haven, FL 33888 -0007
AT1
L -19- 2602 -F592 H
003125
CITY OF OKEECHOBEE
55 SE 3RD AVE
OKEECHOBEE FL 34974 -2903
Insured: HULSEY, WILLIAM & MYRTLE
Location: 204 SE 4TH ST
OKEECHOBEE FL
34974 -4434
Loss Settlement Provisions (See Policy)
Al Replacement Cost - Similar Construction
B1 Limited Replacement Cost - Coverage B
Forms, Options, and Endorsements
Homeowners Policy
Back -Up of Sewer or Drain
Hurricane Deductible
Motor Vehicle Endorsement
Fungus (Including Mold) Excl
Amendatory Collapse
Ordinance /Law 25 %/ $42,275
Special Limits - Money /Jf
Increase Dwlg up to $33,820
Sinkhole Cat Grnd Cvr Coll Cov
Amendatory Debris Removal
Mandatory Reportng Endorsement
** FL EMPA ASSESSMENT
FP- 7955.FL
FE- 5702.1
FE- 5703.3
FE -5396
FE -5453
FE -5714
OPT OL
FE -5258
OPT ID
FE -5445
FE -5480
FE -5801
F
RENEWAL CERTIFICATE
POLICY NUMBER
59 33 -9534 0
Homeowners Policy
APR 03 2011 to APR 03 2012
TO BE PAID BY INSURED
Coverages and Limits
Section I
A Dwelling
Dwelling Extension Up To
B Personal Property
C Loss of Use
Deductibles - Section I
Other Losses
Hurricane 2.00%
$169,100
16,910
126,825
Actual Loss
Sustained
500
3,382
Section II
L Personal Liability $100, 000
Damage to Property of Others 500
M Medical Payments to Others 5,000
(Each Person)
Non - Hurricane Prem $1,236.76
Hurricane Prem $1,287.24
FHCF ASSESSMENT 32.82
2009 FL GUARANTY 23.48
2005 CITIZENS -REG 3.03
2005 FL GUARANTY -EM 3.03
* *Adl Surchg(See Below) 37.34
Total Amount $2,623.70
Inflation Coverage Index: 227.9
2.00 2005 CITIZENS -EM 35.34
gf Hurricane Deductibles may be per calendar year. There is also a possibility that the deductible applied
c at the time of hurricane Toss may be different than the amount shown. Refer to the applicable hurricane
deductible and/or hurricane coverage endorsement attached to this policy. Please contact your State
Farm agent if you have any questions.
Please help us update the data used to determine your premium. Contact your agent with the year each of
your home's utilities (heating /cooling, plumbing, or electrical) and roof were last updated.
0
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17717
N
014
901 M Agent GRETCHEN ROBERTSON INS AGY IN REB
Telephone (863) 763 -5561 or (863) 763 -5562
Moving? See your State Farm agent.
See reverse for important information.
Prepared DEC 14 2010
138 -3076 f.7 Rev. 11 -14 -2005 (o1f3089b)
N Telephone (863) 763 -5561 or (863) 763 -5562
State Farm Florida Insurance Company
7401 Cypress Gardens Blvd.
Winter Haven, FL 33888 -0007
AT 1 G-19- 2602 -F592 H F
003649
CITY OF OKEECHOBEE
55 SE 3RD AVE
OKEECHOBEE FL 34974 -2903
Insured: HULSEY, WILLIAM & MYRTLE
Location: 204 SE 4TH ST
OKEECHOBEE FL
34974 -4434
Loss Settlement Provisions (See Policy)
Al Replacement Cost - Similar Construction
B1 Limited Replacement Cost - Coverage B
Forms, Options, and Endorsements
Homeowners Policy FP -7955 . FL
Back -Up of Sewer or Drain FE- 5702.1
Hurricane Deductible FE- 5703.3
Motor Vehicle Endorsement FE-5396
Fungus (Including Mold) Excl FE -5453
Amendatory Collapse FE -5714
Ordinance /Law 25 %/ $42,275 OPT OL
Special Limits - Money /Jf FE -5258
Increase DwIg up to $33,820 OPT ID
Sinkhole Cat Grnd Cyr Coll Coy FE-5445
Amendatory Debris Removal FE-5480
RENEWAL CERTIFICATE
POLICY NUMBER 59 -33- 9534 -0
Homeowners Policy
APR 03 2010 to APR 03 2011
TO BE PAID BY INSURED
Coverages and Limits
Section!
A Dwelling
$169,100
Dwelling Extension Up To
16,910
B Personal Property
126,825
C Loss of Use
Actual Loss
Sustained
Deductibles - Section I
Other Losses
500
Hurricane 2.00%
3,382
Section 11
L Personal Liability
$100,000
Damage to Property of Others
500
M Medical Payments to Others
5, 000
(Each Person)
Non - Hurricane Prem
$1,078.98
Hurricane Prem
$1,123.02
FL Guaranty Fund
6.17
FL Guaranty Fund 07
16.29
Citizen 05 Reg Asmt
25.10
FL Guaranty Fund EM
20.26
* *Adl Surchg(See Below)
54.85
Total Amount
$2,324.67
Inflation Coverage Index: 227.9
** FHCF Assessment 22.02 FL EMPA Fund Surcharge
2005 Citizens EM Asmt 30.83
2.00
Hurricane Deductibles may be per calendar year. There is also a possibility that the deductible applied
at the time of hurricane loss may be different than the amount shown. Refer to the applicable hurricane
deductible and /or hurricane coverage endorsement attached to this policy. Please contact your State
Farm agent if you have any questions.
l ita �ei ` f c�S vera gr�� Zee av� do' t it eas ge .
13991 901 M A t GRETCHE BERTSON INS AGY IN
if you have moved, please contact your agent.
See reverse side for important information.
REB
Prepared DEC 14 2009
State Farm Florida Insurance Company
7401 Cypress Gardens Blvd.
Winter Haven, FL 33888 -0007
AT1
G -19- 1938 -F592 H F
006324
CITY OF OKEECHOBEE
55 SE 3RD AVE
OKEECHOBEE FL 34974 -2903
Insured: HULSEY, WILLIAM & MYRTLE
Location: 204 SE 4TH ST
OKEECHOBEE FL
34974 -4434
Loss Settlement Provisions (See Policy)
Al Replacement Cost - Similar Construction
B1 Limited Replacement Cost - Coverage B
Forms, Options, and Endorsements
Homeowners Policy
Back-Up of Sewer or Drain
Hurricane Deductible
Policy Endorsement
Motor Vehicle Endorsement
Fungus (Including Mold) Excl
Amendatory Collapse
Ordinance /Law 25 %/ $42,100
Special Limits - Money /Jf
Increase Dwlg up to $33,680
Sinkhole Cat Grnd Cvr Coll Cov
FP- 7955.FL
FE- 5702.1
FE- 5703.3
FE -5320
FE -5396
FE -5453
FE -5714
OPT OL
FE -5258
OPT ID
FE -5445
RENEWAL CERTIFICATE
POLICY NUMBER 59- 33- 9534 -0
Homeowners Policy
APR 03 2009 to APR 03 2010
TO BE PAID BY INSURED
Coverages and Limits
Section I
A Dwelling
Dwelling Extension Up To
B Personal Property
C Loss of Use
Deductibles - Section I
Other Losses
Hurricane 2.00%
$168,400
16,840
126,300
Actual Loss
Sustained
500
3,368
Section II
L Personal Liability $100,000
Damage to Property of Others 500
M Medical Payments to Others 5,000
(Each Person)
Non - Hurricane Prem
Hurricane Prem
FL EMPA Fund Surcharge
FHCF Assessment
FL Guaranty Fund
FL Guaranty Fund 07
2005 Citizens EM Asmt
Total Amount
Premium Reductions
Claim Free Discount
Inflation Coverage Index: 227.1
Hurricane Deductibles may be per calendar year. There is also a possibility that the deductible applied
M at the time of hurricane loss may be different than the amount shown. Refer to the applicable hurricane
deductible and /or hurricane coverage endorsement attached to this policy. Please contact your State
Farm agent if you have any questions.
k
27065
N
haftestmvec 214 orso t�eeN ci eee
901 nn Agent DAVID HE EIS INS AGENCY INC
Telephone (863) 763 -5561
$861.91
$897.09
2.00
17.59
7.38
35.18
24.62
$1,845.77
304.00
If you have moved, please contact your agent.
See reverse side for important information.
REP
Prepared DEC 16 2008
State Farm Florida Insurance Company
7401 Cypress Gardens Blvd.
Winter Haven, FL 33888 -0007
G -19- 1938 -F592 F H
15717
CITY OF OKEECHOBEE
55 SE 3RD AVE
OKEECHOBEE FL 34974 -2903
Insured: HULSEY, WILLIAM & MYRTLE
Location: 204 SE 4TH ST
OKEECHOBEE FL
34974 -4434
Loss Settlement Provisions (See Policy)
Al Replacement Cost - Similar Construction
B1 Limited Replacement Cost - Coverage B
Forms, Options, and Endorsements
Homeowners Policy
Back -Up of Sewer or Drain
Hurricane Deductible
Policy Endorsement
Motor Vehicle Endorsement
Fungus (Including Mold) Excl
Amendatory Collapse
Ordinance /Law 25 %/ $39,675
Special Limits - Money /Jf
Increase Dwlg up to $31 ,740
Sinkhole Cat Grnd Cvr Coll Cov
11 -14 -2005 (o1f3089b)
th
N
FP- 7955.FL
FE- 5702.1
FE- 5703.3
FE -5320
FE -5396
FE -5453
FE -5714
OPT OL
FE -5258
OPT ID
FE -5445
RENEWAL CERTIFICATE
POLICY NUMBER 59 -33- 9534 -0
Homeowners Policy
APR 03 2008 to APR 03 2009
TO BE PAID BY INSURED
Coverages and Limits
Section I
A Dwelling
Dwelling Extension Up To
B Personal Property
C Loss of Use
Deductibles - Section I
Other Losses
Hurricane 2.00%
Section II
L Personal Liability
Damage to Property of Others
M Medical Payments to Others
(Each Person)
Non - Hurricane Prem
Hurricane Prem
FL EMPA Fund Surcharge
FHCF Assessment
Citizen 05 Reg Asmt
FL Guaranty Fund EM
2005 Citizens EM Asmt
Total Amount
Premium Reductions
Claim Free Discount
Inflation Coverage Index: 214.1
$158,700
15,870
119,025
Actual Loss
Sustained
500
3,174
$100,000
500
5,000
$818.79
$852.21
2.00
16.71
20.05
17.38
23.39
$1,750.53
293.00
Hurricane Deductibles may be per calendar year. There is also a possibility that the deductible applied
at the time of hurricane Toss may be different than the amount shown. Refer to the applicable hurricane
deductible and /or hurricane coverage endorsement attached to this policy. Please contact your State
Farm agent if you have any questions.
Ceta(!� c4sveI`ue r�xc. Z(AEd"¢GKI P
GYM *tee's( Cum ,s7„ soi nn Ag t DAVID HER INS AGENCY INC
Tele . hone (863) 763 -5561
If you have moved, please contact your agent
See reverse side for important information.
Prepared DEC 17 2007
REP
138 -3076 f.7 Rev 11 -14 -2005 (o1f3089b)
N
State Farm Florida Insurance Company
7401 Cypress Gardens Blvd.
Winter Haven, FL 33888 -0007
E -19- 1938 -F592 F H
CITY OF OKEECHOBEE
55 SE 3RD AVE
OKEECHOBEE FL 34974 -2903
111111111111111111111111111111111111111 IIIII III III IIIdId
Insured: HULSEY, WILLIAM & MYRTLE
Location: 204 SE 4TH ST
OKEECHOBEE FL
34974 -4434
Loss Settlement Provisions (See Policy)
Al Replacement Cost - Similar Construction
B1 Limited Replacement Cost - Coverage B
Forms, Options, and Endorsements
Homeowners Policy
Back -Up of Sewer or Drain
Hurricane Deductible
Policy Endorsement
Motor Vehicle Endorsement
Fungus (Including Mold) Excl
Amendatory Collapse
Ordinance /Law 25 %/ $38,925
Special Limits - Money /Jf
Increase Dwlg up to $31,140
FP- 7955.FL
FE- 5702.1
FE- 5703.3
FE -5320
FE -5396
FE -5453
FE -5714
OPT OL
FE -5258
OPT ID
RENEWAL CERTIFICATE
POLICY NUMBER
59-33-9534-0
Homeowners Policy
APR 03 2007 to APR 03 2008
TO BE PAID BY INSURED
Coverages and Limits
Section I
A Dwelling
Dwelling Extension Up To
B Personal Property
C Loss of Use
Deductibles - Section t
Other Losses
Hurricane 2.00%
$155,700
15,570
116,775
Actual Loss
Sustained
500
3,114
Section II
L Personal Liability $100 000
Damage to Property of Others 500
M Medical Payments to Others 5 , 000
(Each Person)
Non - Hurricane Prem
Hurricane Prem
FL EMPA Fund Surcharge
FHCF Assessment
FL Guaranty Fund
Total Amount
Premium Reductions
Claim Free Discount
Inflation Coverage Index: 210.2
Hurricane Deductibles may be per calendar year. There is also a possibility that the deductible applied
at the time of hurricane loss may be different than the amount shown. Refer to the applicable hurricane
deductible and /or hurricane coverage endorsement attached to this policy. Please contact your State
Farm agent if you have any questions.
usawejeac keGf 1�EehteG ER cagavfelw.
Ag t DAVID HE INS AGENCY INC
Telephone (863) 763 -5561
$848.82
$957.18
2.00
18.06
19.14
$1,845.20
317.00
If you have moved, please contact your agent.
See reverse side for important information.
REP
Prepared DEC 22 2006
138 -3076 f.6 Rev. 04 -2005 Printed in U.S.A. (o1f3089a)
State Farm Florida Insurance Company
7401 Cypress Gardens Blvd.
Winter Haven, FL 33888 -0007
E -19- 1938 -F592 F H
CITY OF OKEECHOBEE
55 SE 3RD AVE
OKEECHOBEE FL 34974 -2903
11111. 1Iu. I111. u1uuu1. 1. i1u. Iu11u1iu11uuiii11111111ilul .Ii1.i1
Insured: HULSEY, WILLIAM & MYRTLE
Location: 204 SE 4TH ST
OKEECHOBEE FL
34974 -4434
Loss Settlement Provisions (See Policy)
Al Replacement Cost - Similar Construction
B1 Limited Replacement Cost - Coverage B
Forms, Options, and Endorsements
Homeowners Policy
Back -Up of Sewer or Drain
Hurricane Deductible
Policy Endorsement
Motor Vehicle Endorsement
Fungus (Including Mold) Excl
Amendatory Collapse
Ordinance /Law 25 %/ $36,075
Special Limits - Money /Jf
Increase Dwig up to $28,860
FP- 7955.FL
FE- 5702.1
FE- 5703.3
FE -5320
FE -5396
FE -5453
FE -5714
OPT OL
FE -5258
OPT ID
RENEWAL CERTIFICATE
POLICY NUMBER 6-33 -9
Homeowners Policy
APR 03 2006 to APR 03 2007
TO BE PAID BY INSURED
Coverages and Limits
Section I
A Dwelling
Dwelling Extension Up To
B Personal Property
C Loss of Use
Deductibles - Section I
Other Losses
Hurricane 2.00%
$144,300
14,430
108,225
Actual Loss
Sustained
500
2,886
Section II
L Personal Liability $100, 000
Damage to Property of Others 500
M Medical Payments to Others 5, 000
(Each Person)
Non - Hurricane Prem $920.86
Hurricane Prem $346.14
FL EMPA Fund Surcharge 2.00
Citizens 83.37
Total Amount $1,352.37
Premium Reductions
Your premium has already been reduced
by the following:
Claim Free Discount
Inflation Coverage Index: 194.8
229.00
Hurricane Deductibles may be per calendar year. There is also a possibility that the deductible applied
at the time of hurricane loss may be different than the amount shown. Refer to the applicable hurricane
deductible and/or hurricane coverage endorsement attached to this policy. Please contact your State
Farm agent if you have any questions.
rkele
4756
N
401
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Ag t DAVID HE E1 INS AGENCY INC
Telephone (863) 763 -5561
4-1g 68 3793 1898
See reverse side for important information.
REP
Prepared DEC 23 2005
STATE FARM INSURANCE COW-WC-7.?
State Farm Florida Insurance Company
A STOCK COMPANY HOME OFFICE WINTER HAVEN, FLORIDA
7401 Cypress Gardens Blvd.
Winter Haven, FL 33888 -0007
C- 1938 -F592 F H
CITY OF OKEECHOBEE
55 SE 3RD AVE
OKEECHOBEE FL 34974 -2903
I, 1IIr •Ir1ll,Ir,Ir,,III,.Ir1I.II1I1JI II��IrI��I�I�I�I�rI
Insured: HULSEY, WILLIAM & MYRTLE
Location: 204 SE 4TH ST
OKEECHOBEE FL
Loss Settlement Provisions (See Policy)
Al Replacement Cost - Similar Construction
B1 Limited Replacement Cost - Coverage B
Forms, Options, and Endorsements
Homeowners Policy
Back -Up of Sewer or Drain
Hurricane Deductible
Policy Endorsement
Motor Vehicle Endorsement
Fungus (Including Mold) Excl
Amendatory Collapse
Ordinance /Law 25 %/ $32,725
Special Limits - Money /Jf
Increase Dwlg up to $26,180
FP- 7955.FL
FE- 5702.1
FE- 5703.2
FE -5320
FE -5396
FE -5453
FE -5714
OPT OL
FE -5258
OPT ID
DECLARATIONS PAGE
POLICY NUMBER 59 -33- 9534 -0
Homeowners Policy
APR 03 2005 to APR 03 2006
DATE DUE
PLEASE PAY THIS AMOUNT
TO BE PAID BY INSURED
Coverages and Limits
Section I
A Dwelling
Dwelling Extension Up To
B Personal Property
C Loss of Use
Deductibles - Section I
Other Losses
Hurricane 2.00%
$130,900
13,090
98,175
Actual Loss
Sustained
500
2,618
Section II
L Personal Liability $100 , 000
Damage to Property of Others 500
M Medical Payments to Others 5, 000
(Each Person)
Non - Hurricane Prem
Hurricane Prem
FL EMPA Fund Surcharge
Total Amount
Premium Reductions
Your premium has already been reduced
by the following:
Claim Free Discount
Inflation Coverage Index: 176.8
The Loss Settlement Provisions of your policy have changed. Please read the enclosed Policy
inserts.
For questions, problems, or to obtain information about coverage call: (863) 763 -5561
Agent AVID FESTER INS AGENCY INC
Telephone (863) 763 -5561
Prepared DEC 21 2004
$856.82
$250.18
2.00
$1,109.00
202.00
4-= 68 3596 8179
See reverse side for important information.
Please keep this part for your record.
State Farm Florida Insurance Company
7401 Cypress Gardens Blvd.
Winter Haven, FL 33888 -0007
C- 1938 -F591 F H
CITY OF OKEECHOBEE
55 SE 3RD AVE
OKEECHOBEE FL 34974 -2903
Insured: HULSEY, WILLIAM & MYRTLE
Location: 204 SE 4TH ST
OKEECHOBEE FL
Mortgagee: CITY OF OKEECHOBEE
Forms, Options, and Endorsements
Homeowners Policy -Form 3
Amendatory Endorsement
Replacement Cost- Contents
Back -Up of Sewer or Drain
Bldg Ordinance or Law Covg 25%
Hurricane Deductible
Policy Endorsement
FP- 7923.FL
FE- 7210.5
OPT RC
FE -5702
FE -7571
FE- 5703.1
FE -5320
RENEWAL CERTIFICATE
POLICY NUMBER 59 -33- 9534 -0
HOMEOWNERS SPECIAL FORM POLICY
APR 03 2002 to APR 03 2003
DATE DUE PLEASE PAY THIS AMOUNT
TO BE PAID BY INSURED
/ / (ies /4 �e i/� uss'Eepe .e t G Q, aiy,r cos'taM'e,tr
Agent AVID ESTER I S AGEN i INC o
Telephone (863) 763 -5561
Coverages and Limits
Section I
A Dwelling
Dwelling Extension
B Personal Property
C Loss of Use
Deductibles - Section I
Other Losses
Hurricane
$110,500
11,050
77,350
Actual Loss
Sustained
500
2.00%
Section II
L Personal Liability $100, 000
Damage to Property of Others 500
M Medical Payments to Others 5, 000
(Each Person)
Non - Hurricane Prem
Hurricane Prem
FL EMPA Fund Surcharge
Total Amount
Premium Reductions
Your premium has already been reduced
by the following:
Claim Record Discount
Inflation Coverage Index: 149.5
$726.24
$125.76,
2.00 1
$854.00
115.00
Prepared FEB 07 2002
4-z 68 3018 7898
See reverse side for important information.
Please keep this part for your record.
12
11
10
9
STATE FARM INSURANCE COMPANIES
State Farm Florida Insurance Company
7401 Cypress Gardens Blvd.
Winter Haven, FL 33888 -0007
RENEWAL CERTIFICATE
POLICY NUMBER
59 -33- 9534 -0
HOMEOWNERS SPECIAL FORM POLICY
APR 03 2001 TO APR 03 2002
DATE DUE
PLEASE PAY THIS AMOUNT
TO BE PAID BY INSURED
C- 1938 -F591 F H
CITY OF OKEECHOBEE
55 SE 3RD AVE
OKEECHOBEE FL 34974 -2903
11111111111111111111111111111111111111111111111111111111111111
Insured: HULSEY, WILLIAM & MYRTLE
Location: 204 SE 4TH ST
OKEECHOBEE FL
Mortgagee: CITY OF OKEECHOBEE
Forms, Options, and Endorsements
Homeowners Policy -Form 3
Amendatory Endorsement
Replacement Cost - Contents
Back -Up of Sewer or Drain
Bldg Ordinance or Law Covg 25%
Hurricane Deductible
Policy Endorsement
FP- 7923.FL
FE- 7210.5
OPT RC
FE -5702
FE -7571
FE -5703
FE -5320
Coverages and Limits
Section I
A Dwelling
Dwelling Extension
B Personal Property
C Loss of Use
Deductibles - Section I
Other Losses
Hurricane
$106,500
10,650
74,550
Actual Loss
Sustained
500
2.00%
Section 11
L Personal Liability $100,000
Damage to Property of Others 500
M Medical Payments to Others 5,000
(Each Person)
Non - Hurricane Prem
Hurricane Prem
FL EMPA Fund Surcharge
Total Amount
Premium Reductions
Your premium has already been reduced
by the following:
Claim Record Discount
Inflation Coverage Index: 144.2
$541.21
$100.79
2.00
$644.00
84.00
ice in /tes we ac. 2g e�,X d teivreiet +Ke
Agent
AVID INNS AGEN INC
Telephone (863) 763 -5561 Prepared DEC 19 2000
See reverse side for important information.
Please keep this part for your record.
12
11
10
9
-777 'N7,120- TSv_ COMPANIES
afe State Farm Florida Insurance Company
7401 Cypress Gardens Blvd.
Winter Haven, FL 33888-0007
A STOCK COMPANY WITH HOME OFFICES IN WINTER HAVEN, FLORIDA
DECLARATIONS PAGE
POLICY NUMBER _ _ HOMEOWNERS SPECIAL FORM POLICY
59 -33- 9534 -0 APR 03 2000 TO APR 03 2001
DATE DUE PLEASE PAY THIS AMOUNT
TO BE PAID BY INSURED
C- 1938 -F591 F H
CITY OF OKEECHOBEE
55 SE 3RD AVE
OKEECHOBEE FL 34974 -2903
111111111111111111111111111111111111111111111111111111111111111
Insured: HULSEY, WILLIAM & MYRTLE
Location: 204 SE 4TH ST
OKEECHOBEE: FL
Mortgagee: CITY OF OKEECHOBEE
Forms, Options, and Endorsements
Homeowners Policy -Form 3
Amendatory Endorsement
Replacement Cost - Contents
Back -Up of Sewer or Drain
Bldg Ordinance or Law Ccvg 25%
Hurricane Deductible
FP- 7923.FL
FE- 7210.5
OPT RC
FE -5702
FE -7571
FE -5703
Coverages and Limits
Section I
A Dwelling
Dwelling Extension
B Personal Property
C Loss of Use
Deductibles - Section I
Other Losses
Hurricane
$104,100
10,410
72,870
Actual Loss
Sustained
500
2.00%
Section II
L Personal Liability $100,000
Damage to Property of Others 500
M Medical Payments to Others 5,000
(Each Person)
Non - Hurricane Prem
Hurricane Prem
FL EMPA Fund Surcharge
Total Amount
Premium Reductions
Your premium has already been reduced
by the following:
Renewal Discount
Inflation Coverage Index: 141.1
$367.58
$219.42
2.00
$589.00
51.00
Your Homeowners Special Form 3 policy is being nonrenewed by State Farm Fire and Casualty Company. This
new policy is written by State Farm Florida Insurance Company.
For questions, problems, or to obtain information about coverage call: (941) 763 -5561
Agent DAVID ESTER If TS AGEN iY INC
Telephone (941) 763 -5561
am meowed..
Prepared DEC 16 1999
See reverse side for important information.
Please keep this part for your record.
(;
State Farm Fire and Casualty Company
7401 Cypress Gardens Blvd,
Winter Haven, FL 33888 -0007
z POLICY NUMBER
10 59 -33- 9534 -0
insured:
alit ' IIzd RENEWAL •CERTIFICATE
FIL
HOMEOWNERS SPECIAL FORM POLICY
APR 03 1999 TO APR 03 2000
DATE DUE PLEASE PAY THIS AMOUNT
TO BE PAID BY INSURED
C- 1938 -F591 F H
CITY OF OKEECHOBEE
55 SE 3RD AVE
OKEECHOBEE FL 34974 -2903
11111111111111111111111111111111111111 1111111111111111111
HULSE`i, WILLIAM & MYRTLE
Location: 204 SE 4TH ST
OKEECHOBEE FL
Mortgagee: CITY OF OKEECHOBEE
Forms, Options, and Endorsements
Homeowners Policy -Form 3
Amendatory Endorsement
Replacement Cost - Contents
Back -Up of Sewer or Drain
Bldg Ordinance or Law Covg 25%
Hurricane Deductible
FP -7923
FE- 7210.5
OPT RC
FE -5702
FE -7571
FE -5703
/raq/ ' / 'c' teSteve,M. ke Gw.
Agent AVID ESTER I S AGEN INCA
Telephone (941) 763 -5561 or (941) 763 -5562
t21wCl4S'iAIA'eP6:
Coverages and Limits
Section I
A Dwelling
Dwelling Extension
B Personal Property
C Loss of Use
Deductibles - Section I
Other Losses
Hurricane
$100,200
10,020
70,140
Actual Loss
Sustained
500
2.00%
Section 1I
L Personal Liability $100 000
Damage to Property of Others 500
M Medical Payments to Others 5, 000
(Each Person)
Non - Hurricane Prem
Hurricane Prem
FL EMPA Fund Surcharge
Total Amount
Premium Reductions
Your premium has already been reduced
by the following:
Renewal Discount 6+ Years
Inflation Coverage Index: 135.9
$355.68
$212.32
2.00
$570.00
49.00
Prepared DEC 21 1998
See reverse side for important information.
Please keep this part for your record.
11— 11k 771 " f1J JCvCT COVfAF'F'T;
State Farm Fire and Casualty Company
7401 Cypress Gardens Blvd.
Winter Haven, FL 33888 -0007
RENEWAL CERTIFICATE
POLICY NUMBER _ HOMEOWNERS SPECIAL FORM POL
ICY
59- 33- 9534 -0 APR 03 1998 TO APR 03 1999
DATE D
C- 1938 -F591 F H
CITY OF OKEECHOBEE
55 SE 3RD AVE
OKEECHOBEE FL 34974 -2903
1 I I I I I I I I I I I I I I I I I I I I, I I I I I I I I I I 1 I, I I I I I I 1 I I I I I I I I 1 I I I I I I, I, II
Insured: HULSEY, WILLIAM & MYRTLE
Location: 205 SE 4TH ST
OKEECHOBEE FL
Mortgagee: CITY OF OKEECHOBEE
Forms, Options, and Endorsements
Homeowners Policy -Form 3
Amendatory Endorsement
Replacement Cost - Contents
Back -Up of Sewer or Drain
Bldg Ordinance or Law Covg 25%
Hurricane Coverage Endorsement
FP -7923
FE- 7210.5
OPT RC
FE -5702
FE -7571
FE- 5710.0
PLEASE PAY THIS AMOUNT
Q BEIAI BY INSURED
Coverages and Limits
Section I
A Dwelling
Dwelling Extension
B Personal Property
C Loss of Use
Deductibles - Section I
Other Losses
Hurricane
$84,300
8,430
59,010
Actual Loss
Sustained
500
2%
Section 1I
L Personal Liability $100,000
Damage to Property of Others 500
M Medical Payments to Others 5, 000
(Each Person)
Non - Hurricane Prem
Hurricane Prem
FL EMPA Fund Surcharge
FRPCJUA (1994)
Premium Reductions
Your premium has already been reduced
by the following:
Renewal Discount 6+ Years
Inflation Coverage Index: 135.6
$325.62
$194.38
2.00
6.24
44.00
b i usstrve�a . 2l� r _ `"n, term ca stewreee
Agent DAVID ESTER InfS AGEN f INC
Telephone (941) 763 -5561 or (941) 763 -5562 Prepared FEB 09 1998
See reverse side for important information.
Please keep this part for your record.
STATE FARM INSURANCE COMPANIES
State Farm Fire and Casualty Company
7401 Cypress Gardens Blvd.
Winter Haven, FL 33888 -0007
HOMEOWNERS SPEC]
APR 03 1997 TO
2 POLICY NUMBER
0
59 -33- 9534 -0
FORM POLIC"f
APR 03 1998
C-1938 -F591 F H
CITY OF OKEECHOBEE
55 SE 3RD AVE
OKEECHOBEE FL 34974 -2903
111111111111111111111111111111111111111111111111111111111111111
Insured: HULSEY, WILLIAM & MYRTLE
Location: 205 SE 4TH ST
OKEECHOBEE FL
Mortgagee: CITY OF OKEECHOBEE
Forms, Options, and Endorsements
Homeowners Policy -Form 3
Amendatory Endorsement
Replacement Cost - Contents
Back -Up of Sewer or Drain
Bldg Ordinance or Law Covg 25%
j e jp` / / c' t4t•temAG,e.
Agent DAVID 'ESTER INS AGEN INC
Telephone . (941) 763 -5561
FP -7923
FE- 7210.5
OPT RC
FE -5702
FE -7571
RENEWAL CERTIFICATE
IDATEDUE
PLEASE PAY THIS AMOUNT
TO BE PAID BY INSURED
averages and Limits
Section I
A Dwelling
Dwelling Extension
B Personal Property
C Loss of Use
Deductibles - Section I
All Losses
$82,600
8,260
57 820
Actual Loss
Sustained
500
Section II
L Personal Liability $100,000 500
Damage to Property of Others 5 500
M Medical Payments to Others
(Each Person)
Annual Premium
FL EMPA Fund Surcharge
FWUA (1995)
FRPCJUA (1994)
Premium Reductions
Your premium has already been reduced
by the following:
Renewal Discount 6+ Years
Inflation Coverage Index: 133.0
8
7
4
3
2
T
$457.00
2.00
6.90
3.79
35.00
Prepared FEB 07 1997
See reverse side for important information.
Please keep this part for your record.
12
11
10
9
ATE FARM ANSURANCE COMPANIES
State Farm Fire and Casualty Company
7401 Cypress Gardens Blvd.
Winter Haven, FL 33888 -0007
RENEWAL CERTIFICATE
POLICY NUMBER
59 -33- 9534 -0
HOMEOWNERS SPECIAL FORM POLICY
APR 03 1995 TO APR 03 1996
DATE DUE
PLEASE PAY THIS AMOUNT
TO BE PAID BY INSURED
C- 1938 -00 F
CITY OF OKEECHOBEE
55 SE 3RD AVE
OKEECHOBEE FL 34974 -2903
1, 1111111111111111111111111111111111111111111111111111111111111
Insured: HULSEY, WILLIAM & MYRTLE
Location: 205 SE 4TH ST
OKEECHOBEE FL
Mortgagee: CITY OF OKEECHOBEE
Forms, Options, and Endorsements
Homeowners Policy -Form 3
Amendatory Endorsement
Replacement Costs - Contents
Sewer or Drain Back -Up
Bldg Ordinance or Law Covg 25%
FP -7923
FE- 7210.5
OPT RC
FE- 7442.3
FE -7571
Mae k"_"r r ssteve yac ,yr te. Argampreastesteere.
Agent DAVID HESTER INS AGY INC
Telephone (813) 763 -5561
Coverages and Limits
Section I
A Dwelling
Dwelling Extension
B Personal Property
C Loss of Use
Deductibles - Section I
All Losses
Section II
L Personal Liability
Damage to Property of Others
M Medical Payments to Others
(Each Person)
Annual Premium
FL EMPA Fund Surchg
$68,000
6,800
47,600
Actual Loss
Sustained
Premium Reductions
Your premium has already been reduced
by the following:
Renewal Discount 6+ Years
Inflation Coverage Index: 126.7
500
100,000
500
5,000
$352.00
2.00
30.00
See reverse side for important information.
Please keep this part for your record.
Prepared FEB 07 1995
12
11
10
9
STATE FARM INSURANCE COMPANIES
Et . ha otic: II
e
PCL ( NUM3ER
59 -33- 9534 -0
HOMEOWNERS SPECIAL FORM POLICY
INSURED: HULSSEY, WILLIAM & MYRTLE
CITY OF OKEECHOBEE
55 SE 3RD AVE
OKEECHOBEE FL 34974 -2903
1938/37 C
InIInlnIIiI+ uIn ,IJ,iLJ,ILLJI,iu.JI,.h11•IJJJ.J
Regional Office Use Only
NOTE: DO NOT PAY. THE PREMIUM IS
BEING PAID BY THE INSURED.
DATE DUE
PLEASE PAY THIS AMOUNT
THIS IS FOR INFORMATION ONLY
IF YOU HAVE MOVED, PLEASE CONTACT YOUR AGENT
0503 419 800412300031200 9591003395340025 >
STATE FARM FIRE AND CASUALTY COMPANY
7401 CYPRESS GDNS BL,WINTER HAVEN FL 33888 -0007 PREPARED FEB 08 94
RENEWAL CERTIFICATE
POLICY NUMBER
59-33-9534-0
DATE DUE PLEAS▪ E PAY THIS AMOUNT
TO BE PAID BY INSURED
FULL PAYMENT BY DATE DUE EXTENDS
POLICY PERIOD TO APR 03 95.
INSURED: HULSEY, WILLIAM & MYRTLE
LOCATION: 205 SE 4TH ST
OKEECHOBEE FL
MORTGAGEE: CITY OF OKEECHOBEE
55 SE 3RD AVE
OKEECHOBEE FL 34974 -2903
FORMS, OPTIONS, AND ENDORSEMENTS
SPECIAL FORM 3 FP -7923
AMENDATORY ENDORSEMENT FE- 7210.4
REPLACEMENT COSTS - CONTENTS OPT RC
SEWER OR DRAIN BACK UP FE- 7442.3
INFLATION COVERAGE INDEX: 125.0
See reverse side for important information affecting your insurance.
Please keep this part for your record.
a .d fie&,;:y d dem,,,e/9a.. .
AgentDAVID HESTER INS AGY INC
Telephone 813-763-5561 3
HOMEOWNERS SPECIAL FORM
POLICY
COVERAGES /LIMITS
SECTION I
A DWELLING
DWELLING EXTENSION
B PERSONAL PROPERTY
C LOSS OF USE
DEDUCTIBLES - SECTION I
ALL LOSSES
SECTION II
L PERSONAL LIABILITY
DAMAGE TO PROPERTY
OF OTHERS
M MEDICAL PAYMENTS TO
OTHERS(EACH PERSON)
$ 66 , 70 (
46,90(
ACTUAL LOS;
SUSTAINEC
$500
$ 100,00(
50(
5,00(
ANNUAL PREMIUM $ 310.00
FL EMPA FUND SURCHG $ 2.00
YOUR PREMIUM HAS ALREADY BEEN
REDUCED BY THE FOLLOWING:
RENEWAL DISCOUNT 6+ YEARS $ 27.00
STATE FARM INSURANCE COMPANIES
POLICY NUMBER
Premium Notice
59 -33- 9534 -0
HOMEOWNERS SPECIAL FORM POLICY
INSURED: HULSEY, WILLIAM & MYRTLE
1938/37 C
CITY OF OKEECHOBEE
55 SE 3RD AVE
OKEECHOBEE FL 34974 -2903
11. 111111111,1. 11111111. 111J111J111111111111JJ1111111L11 .1
NOTE: DO NOT PAY. THE PREMIUM IS
BEING PAID BY THE INSURED.
DATE DUE PLEASE PAY THIS AMOUNT
THIS IS FOR INFORMATION ONLY
IF YOU HAVE MOVED, PLEASE CONTACT YOUR AGENT
COIL.
id. 7
6
5
Regional Office Use Only
0503 419 400312300026500 9591003395340025 >
STATE FARM FIRE AND CASUALTY COMPANY RENEWAL CERTIFICATE
7401 CYPRESS GDNS BL,WINTER HAVEN FL 33888 -0007 PREPARED FEB 11 93
POLICY NUMBER DATE DUE PLEASE PAY THIS AMOUNT I HOMEOWNERS SPECIAL FORM POLICY
59 -33- 9534 -0 ITO BE PAID BY INSURED
FULL PAYMENT BY DATE DUE EXTENDS
POLICY PERIOD TO APR 03 94.
COVERAGES /LIMITS
SECTION I
A DWELLING $ 64,000
INSURED: HULSEY, WILLIAM & MYRTLE DWELLING EXTENSION $ 6,400
B PERSONAL PROPERTY $ 44,800
C LOSS OF USE ACTUAL LOSS
SUSTAINED
LOCATION: 205 SE 4TH ST
OKEECHOBEE FL
DEDUCTIBLES — SECTION I
ALL LOSSES $500
MORTGAGEE: CITY OF OKEECHOBEE
55 SE 3RD AVE SECTION II
OKEECHOBEE FL 34974 -2903 L PERSONAL LIABILITY $ 100,000
DAMAGE TO PROPERTY
OF OTHERS $ 500
M MEDICAL PAYMENTS TO
OTHERS(EACH PERSON) $ 5,000
FORMS, OPTIONS, AND ENDORSEMENTS
SPECIAL FORM 3 FP -7923
AMENDATORY ENDORSEMENT FE- 7210.4
REPLACEMENT COSTS— CONTENTS OPT RC
SEWER OR DRAIN BACK UP FE- 7442.3
INFLATION COVERAGE INDEX: 119.5
See reverse side for important information affecting your insurance.
Please keep this part for your record.
AgentDAVID HESTER INS AGY INC
Telephone 813 - 763 -5561
0
ANNUAL PREMIUM $ 265.00
YOUR PREMIUM HAS ALREADY BEEN
REDUCED BY THE FOLLOWING:
RENEWAL DISCOUNT 6+ YEARS $ 25.00
12
11
10
9
pp STATE FARM INSURANCE COMPANIES
R� �; ' _ iuim Mr tirni poL Cf N 3ER
HOMEOWNERS SPECIAL FORM POLICY33- 9534 -0
INSURED: HULSEY, WILLIAM & MYRTLE
( ullnlnll1lnln •l1lulnl1H•111111.1nll111ln1
1938/37 C
CITY OF OKEECHOBEE
55 SE 3RD AVE
OKEECHOBEE FL 34974 -2903
Regional DNice Use Only
NOTE: DO NOT PAY. THE PREMIUM IS
BEING PAID BY THE INSURED.
DATE DUE PLEASE r - T +;I /4,C Lt
THIS IS FOR INFORMATION ONLY
IF YOU HAVE MOVED, PLEASE CONTACT YOUR AGENT
0503
419 800212400018000 9591003395340025 >
STATE FARM FIRE AND CASUALTY COMPANY RENEWAL CERTIFICATE
J 3425 LAKE ALFRED RD, WINTER HAVEN FL 33888 -0007 PREPARED FEB 11 92
POLICY NUMBER
DATE DUE PLEASE PAY THIS AMOUNT
59 -33- 9534 -0 TO BE PAID BY INSURED
FUL. PAYMENT BY DATE DUE EXTENDS
POLICY PERIOD TO APR 03 93.
INSURED: HULSEY, WILLIAM & MYRTLE
LOCATION: 205 SE 4TH ST
OKEECHOBEE FL
MORTGAGEE: CITY OF OKEECHOBEE
55 SE 3RD AVE
OKEECHOBEE FL 34974 -2903
FORMS, OPTIONS, AND ENDORSEMENTS
SPECIAL FORM 3 FP -7923
AMENDATORY ENDORSEMENT FE- 7210.4
INFLATION COVERAGE INDEX: 117.2
See reverse side for important information affecting your insurance.
Please keep this part for your record.
Tea 164 4Z,
Agent DAVID HESTER INS AGY INC
Telephone 813 - 763 -5561 0
HOMEOWNERS SPECIAL FORM POLICY
COVERAGES /LIMITS
SECTION I
A DWELLING
DWELLING EXTENSION
B PERSONAL PROPERTY
C LOSS OF USE
DEDUCTIBLES - SECTION I
ALL LOSSES
SECTION II
L PERSONAL LIABILITY
DAMAGE TO PROPERTY
OF OTHERS
M MEDICAL PAYMENTS TO
OTHERS(EACH PERSON)
$
53,600 5 0
$ 29,480
ACTUAL LOSS
SUSTAINED
$500
$ 100,000
$ 500
$ 5,000
ANNUAL PREMIUM $ 180.00
YOUR PREMIUM HAS ALREADY BEEN
REDUCED BY THE FOLLOWING:
RENEWAL DISCOUNT 6+ YEARS $ 22.00
STATE FARM INSURANCE COMPANIES
POLICY NUM
79- 33- 9534 -0
HOMEOWNERS SPECIAL FORM POLICY
Premium Notice
INSURED: HULSEY, WILLIAM & MYRTLE
1938/70 K
CITY OF OKEECHOBEE
55 SE 3RD AVE
OKEECHOBEE FL 34974 -2932
THE I NOTE:
BEING NOT THE INSURED.
IS
DATE DUE PLEASE PAY THIS AMOUNT
THIS IS FOR INFORMATION ONLY
IF YOU HAVE MOVED, PLEASE CONTACT YOUR AGENT
Regional Office Use Only
0503
419 400112300017300 0792003395340025 >
STATE FARM FIRE AND CASUALTY COMPANY RENEWAL CERTIFICATE
3425 LAKE ALFRED RD, WINTER HAVEN FL 33888 -0007 PREPARED FEB 11 91
HOMEOWNERS SPECIAL FORM POLICY
POLICY NUMBER DATE DUE PLEASE PAY THIS AMOUNT
79- 33-9534 -0 ITO BE PAID BY INSURED
POLICY PERIODBTODAAPRD03 WENDS
INSURED: HULSEY, WILLIAM & MYRTLE
LOCATION OKEECHOBEE FL
MORTGAGEE: CITY OF OKEECHOBEE
55 SE 3RD AVE
OKEECHOBEE FL 34974 -2932
FORMS, OPTIONS, AND ENDORSEMENTS
SPECIAL FORM 3 FP-7193
AMENDATORY ENDORSEMENT FE-7210.3
DEBRIS REMOVAL ENDORSEMENT FE-7540
INFLATION COVERAGE INDEX: 114.2
See reverse side for important information affecting your insurance.
Please keep this part for your record.
AgentDAVID HESTER INS AGY INC 2
Telephone 813-763-5561
COVERAGES /LIMITS
SECTION I
A DWELLING
DWELLING EXTENSION
B PERSONAL PROPERTY
C LOSS OF USE
DEDUCTIBLES — SECTION I
ALL LOSSES
SECTION II
L
DAMAGE ATOLPROPERTY
OF OTHERS
M OTHERS(EACHM TO
PERSON)
$ 52,20'
$ ACTUALBLOSOS
SUSTAINED
$500
$ 100,000
$ 500
$
5,000
ANNUAL PREMIUM $ 173.0
YOUR PREMIUM HAS ALREADY BEEN
REDUCED BY THE FOLLOWING:
RENEWAL DISCOUNT 6+ YEARS $ 21.0
STATE FARM INSURANCE COMPANIES
t=all 0 11
Pa.' JY NUMBER
79-33-9534-0
HOMEOWNERS SPECIAL FORM POLICY
INSURED: HULSEY, WILLIAM & MYRTLE
1938/70 K
CITY OF OKEECHOBEE
55 SE 3RD AVE
OKEECHOBEE FL 34974 -2932
NOTE: DO NOT PAY. THE PREMIUM IS
BEING PAID BY THE INSURED.
DATE DUE
PLEASE PAY THIS AMOUNT
SEE NOTE ABOVE
IF YOU HAVE MOVED, PLEASE CONTACT YOUR AGENT
Regional Office Use Only
CA*
0516 419 500013600015700 0792003395340025 >
STATE FARM FIRE AND CASUALTY COMPANY
RENEWAL CERTIFICATE
3425 LAKE ALFRED RD, WINTER HAVEN FL 33888 -0007 PREPARED FEB 09 90
POL.ICY NUMI3ER DATE DUE PLIEASE PAY THIS AMOUNT
79- 33- 9534 -0 TO BE PAID BY INSURED
POPAYMENT BY
LICYPERIODTOAAPRD0 EXTENDS
INSURED: HULSEY, WILLIAM & MYRTLE
LOCATION: 205 SE 4TH ST
OKEECHOBEE FL
MORTGAGEE: CITY OF OKEECHOBEE
55 SE 3RD AVE
OKEECHOBEE FL 34974 -2932
FORMS, OPTIONS, AND ENDORSEMENTS
SPECIAL FORM 3 FP -7193
AMENDATORY ENDORSEMENT FE-7210.3
INFLATION COVERAGE INDEX: 111.6
See reverse side for important information affecting your insurance.
Please keep this part for your record.
i i�e?� 4 46y II /I ww.. .
AgentDAVID HESTER INS A GY INC
Telephone
813 - 763 -5561
HOMEOWNERS SPECIAL FORM POLICY
COVERAGES /LIMITS
SECTION I
A DWELLING $ 51,00
DWELLING EXTENSION $ 5,100
B PERSONAL PROPERTY $ 28,05
C LOSS OF USE ACTUAL LOS
SUSTAINED
DEDUCTIBLES - SECTION I
ALL LOSSES $500
SECTION II
L PERSONAL LIABILITY $ 100,00
DAMAGE TO PROPERTY
OF OTHERS $ 50
M MEDICAL PAYMENTS TO
OTHERS(EACH PERSON) $ 5,00
ANNUAL PREMIUM $ 157.00
YOUR PREMIUM HAS ALREADY BEEN
REDUCED BY THE FOLLOWING:
RENEWAL DISCOUNT 6+ YEARS $ 19.00
STATE FARM INSURANCE COMPANIES
Premium Notice
POLICY NUMBER
79 -33- 9534 -0
HOMEOWNERS SPECIAL FORM POLICY
INSURED: HULSEY, WILLIAM & MYRTLE
1938/70 K
CITY OF OKEECHOBEE
55 SE 3RD AVE
OKEECHOBEE FL 34974 -2932
NOTE: DO NOT PAY. THE PREMIUM IS
BEING PAID BY THE INSURED.
DATE DUE PLEASE PAY THIS AMOUNT
SEE NOTE ABOVE
IF YOU HAVE MOVED, PLEASE CONTACT YOUR AGENT
Regional Office Use Only
0516
419 400913600014600 0792003395340025 >
STATE 33888 -0007 PREPAREDFEB08 CERTIFICATE
89
POLICY NUMBER
79 -33- 9534 -0
DATE DUE PLEASE PAY THIS AMOUNT HOMEOWNERS SPECIAL FORM POLICY
TO BE PAID BY INSURED
INSURED:
T BY DATE DUE EXTENDS
Of- ' 3 90.
HULSEY, WILLIAM & MYRTLE
LOCATION: 205 SE 4TH ST
OKEECHOBEE FL
MORTGAGEE: CITY OF OKEECHOBEE
55 SE 3RD AVE
OKEECHOBEE FL 34974 -2932
FORMS, OPTIONS, AND ENDORSEMENTS
SPECIAL FORM 3 FP -7193
AMENDATORY ENDORSEMENT FE- 7210.3
INFLATION COVERAGE INDEX: 101.9
See reverse side for important information affecting your insurance.
Please keep this part for your record.
i' uI IIu'I ra..
AgenDAVID HESTER INS A GY INC
Telephone
813 - 763 -5561
COVERAGES /LIMITS
SECTION I
A DWELLING $ 46,500
DWELLING EXTENSION $ 4,650
B PERSONAL PROPERTY $ 25,575
C LOSS OF USE ACTUAL LOSS SUSTAINED
DEDUCTIBLES — SECTION I
ALL LOSSES
SECTION II
L PERSONAL LIABILITY
DAMAGE TO PROPERTY
OF OTHERS
M MEDICAL PAYMENTS TO
OTHERS(EACH PERSON)
$500
$ 100,000
$ 500
$ 5,000
ANNUAL PREMIUM $ 146.0(
YOUR PREMIUM HAS ALREADY BEEN
REDUCED BY THE FOLLOWING:
RENEWAL DISCOUNT 6+ YEARS $ 18.0(
i
Al
STATE FARM INSURANCE COMPANIES
POLICY NUMBER
79 -33- 9534 -0
HJMEOr+IVEKS SPECIAL F)i M P.) ICY
Premium Notice
INSURED: HULSEY, WILLIAM & MYRTLE
1938/70 K
CITY OF OKEECHOBEE
55 SF 3RD AVE
OKEECHOBEE FL 34974 -2932
Regional Office Use Only
VOTE: DO NOT PAY. THE PRE`1IUM IS
BEING PAID BY THE INSURED.
DATE DUE PLEASE PAY THIS AMOUNT
SEE NOTE ABOVE
IF YOU HAVE MOVED, PLEASE CONTACT YOUR AGENT
1
7515 419 500813700016100 7792013395340025 >
STATE FARM FIRE AND CASJALTY COMPANY
vENEAAL CERTIFICATE
342_S LAKE ALFRED RD, WINTER HAVEN FL 33888-0737
PLEASE PAY THIS AMOUNT I SPECIAL FORM POLICY
T3 BE PAID 3Y INSURED
POLICY NUMBER DATE DUE
79 -33- 9534 -1
FULL pA
POt CY;,
N* gY DATE DE !XTEDS
' 1 AP1� `,..3 1�
4ULSEY, WILLIAM & MYRTLE
INSURED:
LOCATION: 275 SE 4TH CT
OKECi:H03Lk FL
COVERAGES /LIMITS
SECTION I
A DWELLING $ 45,7000
DWELLING EXTENSION $ 4,
B PERSONAL PROPERTY $ 25,135
C LOSS OF USE ACTUAL LOSS
SUSTAINED
a
DEDUCTIBLES - SECTION I $500
ALL LOSSES
MORTGAGEE: CITY OF OKEECH09EE SECTION II
55 SE 3RD AVE L PERSONAL LIABILITY S 100,000
OKE =_CHO3EE FL 34974 -2932 DAMAGE TO PROPERTY
OF OTHERS $ 500
M MEDICAL PAYMENTS TO S OOC
OTHERSCEACH PERSON) $ •
FORM.; OPTIONS, AND ENDORSEMENTS
SPECIAL FORM : FP -7193
FL AMENDATORY ENDORSEMENT FE- 7210.3
INFLATION COVERAGE 1N)EX: 103.4
See reverse side for important information affecting your insurance.
Please keep this part for your record.
al iota
AgenDAVID HESTER INS AGY INC
Telephone 313- 7o3 -55o1
ANNUAL PREMIUM
$ 161.0
lal
STATE FARM INSURANCE COMPANIES
POLICY NUUiI3ER
7Q-33-C,4-11
L FORP POLICY
Premium Notice
HOMEOWNERS SPECI
INSURED: WILSEY, MUM $ MYRTLE
1938/70 K
CITY OF OKEECF!0BEE
55 SE 3RD AVE
OKEECHOBEE FL 33474-2932
} CTE: DO NCT PI:Y., THE PREMIUM I S
BEING PAID FY THE If SUFEt.
DATE DUE
PLEASE PAY TH S AM ,1 UN -"
SEE NOTE IECVE
IF YOU HAVE MOVED SEE RE VERSE SID
Regional Office Use Only
419 800713600016000 0792003395340025 >
STATE Wit* FIRE AND CASUALTY COMPANY
3425 LA =E ALFRED RD,4ilNTER HAVEN FL 33888 -0007
POLICY NUMBER
79-33- 9534 -0
DATE DUE
RENEWAL CERTIFICATE
PREPARED FEB Of 87
PLEASE PAY THIS AMOUNT 1HOMEOWNERS SPECIAL FORV POLICY
TO BE PAID ELY INSURED
JEJ DS
INSURED: HULSE:Y, WILLIAM & MYRTLE
LOCATION:
205 SE 4TH ST
OKEECHOBEE FL
MORTGAGEE: CITY OF OKEECHOBEE
55 SE 3RD AVE
OKEECHOBEE FL 33474 -2932
FORM ".S OPTIONS, AND ENDORSEMENTS
SPECIAL FORM 3 FP- 7183.1
FL AMENDATORY ENDORSEMENT FE- 7210.2
LOSS SETTLEMT FE -7456
CHILD CARE EXL FE -7489
INFLATION COVERAGE INDEX: 102.5
See reverse side for important information affecting your insurance.
Please keep this part for your record.
Vaeid 46y ad la Aero .. .
Agent DAVID HESTER INS AGY INC
Telephone 813 -763 -5561
COVERAGES /LIMITS
SACTDWELLING i
DWELLING EXTENSION 1
E! PERSONAL PROPERTY $
C LOSS OF USE
45,200
4,520
24,860
ACTUAL LOSS
SUSTAINED
DALLCLOSSES - SEC 115000 I
SECTION II
L PERSONAL LIABILITY
DAMAGE TO PROPERTY
M MEDICAL PAYMENTS TO
OTHERS(EACH PERSON)S
ANNUAL PREMIUM
100,000
500
5,000
160.00
POLICY NUMBER •
79 -33- 4534 -D
AMOUNT ^'2E
SEE "NOT!":"
^ATE DUE 1938 in
SEE "NOTE" 711,
NOTE: THIS IS A COPY OF THE FREMIUM NOTICE SENT TO ThE INSURED. DO NOT PAY.
CITY CF OKEECHOBE!
55 SE 3RD AVE
OKEECHOBEE FL 33472
IF YOU HAVE MOVED SEE REVERSE SIDE
HULSEY, WILLIAM & MYRTLE
BOX 596
COLLEGEDALE TN 37315
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STATE FARM FIRE AND CASUALTY COMPANY
3425 LAKE ALFRED RD
wINTER HAVEN FL 33688
0516
419 630513600014800 0792003395340025 >
PLEASE KEEP THIS PART FOR YOUR RECORD
STATE FARM, FIRE ANL CASUALTY COMPANY AGENT DAVID HESTER INS AGY INC
RENEWAL CERTIFICATE PREPARED FEB 13 85 TELEPHONE 813-763-5561
POLICY PERIOD
APR 03 85 TO APR 03 86
HOMEOWNERS POLICY 79- 33- 9534 -C
INSURED: HULSEY, wILLIAP & MYRTLE
LOCATION: OMKCEECHOBEE FL
DEDUCTIBLES - SECTION I
ALL LOSSES $500
FORMS OPTICNS, AND ENDORSEMENTS
* FP- 7183.1 SPECIAL FORM:
FE- 721L.2 AMENDATORY END
FE -1456 LOSS SETTLEMT
*EFFECTIVE APR O3 85
INFLATION COVERAGE - THE INFLATION COVERAGE
INDEX IS 164.9.
COVERAGE LIMITS
SECTION I 44,100
A DWELLING 4 110
DWELLING EXTENSION $ •
8 PERSONAL PROPERTY $ ACTUAL LOSS
C LOSS OF USE SUSTAINED
SECTION I1
L PERSONAL LIABILITY $ 1C0,000
DAMAGE TO PROPERTY 500
OF OTHERS
M MEDICAL PAYMENTS 10
OTHERS(EACH PERSON)$ 5,000
PAYMENT EXTENDS POLICY PERIOD TO APR 03 86. ANNUAL PREMIUM
638 -141 Printed in U.S.A. SEE REVERSE SIDE FOR IMPORTANT INFORMATION
148.00