Blk 33 1st Add So Okee/Ida Harrell/AlleyALLEY USE LICENSE
THIS LICENSE, BY AND BETWEEN THE CITY OF OKEECHOBEE, FLORIDA, a Florida
Municipal corporation (hereinafter "CITY "), and Ida Harrell, (hereinafter
"OWNER(S) "), dated this 4th day of cctoter , 2007.
WHEREAS, OWNER (S) hold fee simple title to the following described real property in
Okeechobee County, Florida, to wit:
Lots 3 and 4 of Block 33, 1 s` Addition to South Okeechobee, according to
the Plat thereof recorded in Plat Book 1, Page 17, public records of
Okeechobee County, Florida; and
WHEREAS, City owns the following alleyway:
That 15 foot wide alleyway running North to South and located between
Lots 3 and 4 and Lots 9 and 10 of Block 33, First Addition to South
Okeechobee, according to the Plat thereof recorded in Plat Book 1, Page
17, public records of Okeechobee County, Florida; and
WHEREAS, the OWNER(S) desire to make certain improvements in the form of erecting a
fence or any other item on a portion (7 and one -half feet) of the East side of the alley
right -of -way between Lots 3 and 4 and 9 and 10, in said Block 33, which is an open
unimproved alleyway, which is owned by the CITY.
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 alleyway with the
understanding the OWNER(S) will maintain the alleyway and should it ever
become necessary to remove any fencing, landscaping 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, landscaping 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, landscaping or any improvements thereon less than seven days
notice, the OWNER 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 with a certificate furnished to the CITY showing
the portion of the alleyway 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 alleyway. 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. That OWNER(S) shall not, by such improvements made to that described
alleyway, obstruct, close or otherwise restrict access to the alleyway for travel
thereon by the CITY or the general public.
4. That the OWNER(S) agree that this license is non - assignable without the
express written consent of the CITY; and if transferred, the covenants herein
shall bind themselves, their heirs and assigns, and said covenants shall run with
the land.
Page 1 of 2
!edged before me this day of
c
tyre( , who signed in the presence of these
as identification or is personally
/ r /
Notary Public Signature
1== c:tc( r.(
Name of Notary typed, printed1or stamped)
Commission No. i>L '/ -5'/.
, MEUSAM.EDDINGS
MY COMMISSION # DD 403572
.�� EXPIRES: March 7, 2009
44, Bonded Thru Notary Public Underwriters
5. The City Clerk shall cause this Iicentse to be recorded in the public records of
Okeechobee County, Florida.
IN WITNESS WHEREOF, the parties hereto set their hands and seals on the aforesaid date.
Signed, sealed and delivered in presence of:
i!
ri`1' l(e cam.( /�
(Witness Signature)
Lit)? c7arn,
(Witness Printed Name)
c 5, 23ci!ve, 01-e (}k/c)E,021 C1,31-67L(
(Witness Address)
STATE OF FLORIDA
COUNTY OF ( N,)(
The foregoing instrument was acknow
(,4-t'1A,1- , 20 C"7, by tt
witnesses; and who produced
Ida Harrell
r,-
Bess Signature)
k c lil y✓
(Witness Printed Nariie)
(Witness Address)
known.
Accepted for the City:
��a/-
Donnie Robertson, Public Works Director
Reviewed for Legal Sufficiency:
J C
John R. Cook, ity Attorney
(city seal)
Page 2 of 2
City of Okeechobee
55 S.E. Third Avenue • Okeechobee, Florida 34974 -2932 • 813/763-3372
October 1, 1992
(A O9,_ ti c4 ect. o1c;LL (1 /1l /lq(9 )
LETTER OF AGREEMENT
The City of Okeechobee hereby grants Shawn McGushion, owner of lots
3 & 4, Block 33, First addition to South Okeechobee (1706 S.W. 2nd
Avenue) permission to erect a fence or any other item on a portion
(7 and 1/2 feet) of the Fast side of the alley right -of -way, this
will leave half of the right -of -way on the West side open at this
time.
This agreement constitutes a mere license from the City for the
wanted use, and is revocable by the City at any time upon demand.
Shawn McGushion (owner) agrees if at any time the City requires the
use of said Alley right of way for the installation of utilities or
for any other purpose not limited to drainage, etc., to remove
said fence or any other item at owners expense. within thirty (30)
days after receiving written notice. If in fact the City requires
earlier removal of said fence or any other item, then the City
employees or agents may at the City's expense remove said fence or
any other item and will try to preserve the fence or anv other item
to the best of their ability; and if replacement of the fence or
any other item is allowed, it will remain the owner's full
responsibility.
The City and its employees will be held harmless,and indemnified by
owner now and in the future, from any and all claims that may arise
in connection to this granted use of street right -of -way by the
owners, their guests, invitees or the public.
Furthermore, it shall be a requirement of this agreement that the
granted right -of -way be properly maintained at all times with no
expenses to be incurred by the City.
Charles Elders
Director of Public Works
Ben Lofton
4
Shawn McGushion - Owner
Bonnie S. Thomas
Director of Public Utilities City Clerk
Nationwide' '
On Your Side"
NATIONWIDE INS CO OF FLORIDA
1100 LOCUST ST
DES MOINES IA 50391 -1100
(800) 282 -1446
AGENCY JOHN PERRY INSURANCE AGENCY
OKEECHOBEE FL
CONTINUATION DECLARATIONS
NAME INSURED AND ADDRESS
HARRELL, IDA B.
1706 SW 2ND AVE
OKEECHOBEE, FL 34974 -6186
The limit of liability for the structure (Coverage A) is based on the estimate of the cost to rebuild your home, including an approaomate
cost for labor and materials in your area, and specific information that you have provided about your home.
HOMEOWNERS POLICY
POLICY NUMBER: HOF 0025224702 -2
ACCOUNT NUMBER: 885303551
Policy Period
From: 08 -28 -11 To: 08 -28 -12
12:01 A.M. Standard Time
Effective Date of Change
The described residence premises covered hereunder is located at the
above address, unless otherwise stated herein. (No., Street, City, State, Zip Code)
PREVIOUS POLICY NUMBER HOF 0025224702-
1706 SW 2ND AV
OKEECHOBEE, FL
34974 -6186
TO BE PAID BY NAMED INSURED
COVERAGE AND LIMITS OF
ABILITY
SECTION I
SECTION II
A. DWELLING
B. OTHER
STRUCTURES
C. PERSONAL
PROPERTY
D. LOSS
OF USE
E. PERSONAL
LIABILITY
F. MEDICAL PAY
EACH PERSON
134,200
2,684
67,100
13,420
300,000
1,000
FOR LOSSES ARISING UNDER SECTION 1, WE WILL PAY ONLY THAT PART OF THE LOSS IN EXCESS OF $500,
EXCEPT FOR LOSS BY HURRICANE, FOR WHICH WE WILL PAY ONLY THAT PART OF THE LOSS
IN EXCESS OF 2% OF COVERAGE A.
COVERAGE
DESCRIPTION
PREMIUM
COVERAGES
DESCRIPTION
PREMIUM
BASIC COVERAGE
H03 01/00
Special Form
1,205.54
12501S 08/08
ORD OR LAW
12501AS 08/08
SURCHARGES
12501HD 08/08
HURR DEDUCTIBLE
12501PC 08/08
PREM CHG INFO
H0277FL 08/08
Ord or Law - 50%
60.28
12669 08/08
Back -up of Sewer
8.50
H048 01/00
Oth Str Incr Lim
27.75
H070 01/00
Addl Res Rented
7.83
12559A 08/08
Per Prop Repl
180.83
12567F 08/08
Replacement Cost
4.27
16372 05/09
Sinkhole Collaps
20.13
12747 09/08
Biological Det
H0216 08/08
Prem Alarm Prot
11.38CP
HO300FL 09/08
Spec Provisions
IN2525 08/08
Opt Ded Offer
IN2532 08/08
Checklist of Cov
IN2537 08/08
Outline of Cov
IN2542 08/08
Hurr Mit Dsc Int
H041 01/00
Add Ins Res Prem
12800 08/08
Hurricane Prov
IN0000F 05/09
Privacy Stmt
1N2531 07/10
FL Hurr Cat Fund
IN2533 07/10
Loss Mitigation
(CONTINUED)
TOTAL SURCHARGES
36.55
TOTAL ANNUAL
RENEWAL AMT DUE
1,540.34
Additional
Residence
Occupied
By Insured
Mortgage Loss Payee or Other Interest
Loan Number'
4000509349/1
SEACOAST NATIONAL BANK
CITY OF OKEECHOBEE
STUART, FL
LANE GAMIOTEA
55 SE 3RD AVE
OKEECHOBEE, FL 349742903
NATIONWIDE INS CO OF FLORIDA
Authorized Representative
DIRECT BILL 0000 11187
003801
MEMO COPY
T 885303551 59
Policy Number: HOF 0025224702 -2
Declarations Continued:
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.
Your policy includes Ordinance or Law Coverage at
25% of Coverage A.
Issued By: Nationwide Insurance Company of Florida
Countersigned at: Gainesville, FL
By: JOHN PERRY INSURANCE AGENCY
How To Contact Us
Your Agent JOHN PERRY INSURANCE AGENCY
Customer Care Center 1- 800 -282 -1446
Internet www.nationwideonyourside.com
Hearing Impaired (TTY) 1- 800 -622 -2421
24 -Hours Claims Reporting 1 -800- 282 -1446
(863) 983 -8222
12501S (08 -08)
HOF 00252247022 07/06/11 003602 MEMO COPY 59
Policy Number: HOF 0025224702 -2
Declarations Continued:
Assessments and Surcharges
EMERGENCY MANAGEMENT PREPAREDNESS AND ASSISTANCE TRUST FUND SURCHARGE
FLORIDA HURRICANE CATASTROPHE FUND 2006 EMERGENCY ASSESSMENT
CITIZENS PROPERTY INSURANCE CORPORATION 2005 EMERGENCY ASSESSMENT
Total Assessments and Surcharges
12501 AS (08 -08)
HOF 00252247022 07/06/11 003603
MEMO COPY
$2.00
$19.55
$15.04
$36.59
Policy Number: HOF 0025224702 -2
Declarations Continued:
THIS POLICY CONTAINS A SEPARATE DEDUCTIBLE FOR
HURRICANE LOSSES, WHICH MAY RESULT IN HIGH
OUT -OF- POCKET EXPENSES TO YOU.
Your policy contains a 2% hurricane deductible = $2,684.
THE HURRICANE DEDUCTIBLE MAY BE HIGHER THAN
INDICATED WHEN A LOSS OCCURS DUE TO THE
APPLICATION OF THE INFLATION GUARD RIDER.
12501HD (08 -08)
HOF 00252247022 07/06/11 003604
MEMO COPY
Declarations Continued:
Renewal Premium Changes:
Total Premium Change = $ 190.07
Assessment Change = $ -21.00
Rate Change - Premium = $ 211.07
Coverage Change - Premium = $ 0.00
Renewal Premium Detail:
Hurricane Premium
Non-Hurricane Premium
$ 636.45
$ 982.52
Policy Number: HOF 0025224702-2
Annual Renewal Premium before Surcharges, Assessments and Discounts $ 1,618.97
12601PC (08-08)
HOF 00252247022 07/06/11 003605
MEMO COPY
NATIONWIDE INSURANCE COMPANY OF FLORIDA
IN WITNESS WHEREOF, the Company has caused this policy to be signed by its president and secretary and
countersigned as may be required on the declarations page by a duly authorized representative of the company.
6g,c 77
SECRETARY
IP
PRESIDENT
15651F (08 -08) Page 1 011
HOF 00252247022
07/06/11 003606 MEMO COPY
ADDITIONAL ENDORSEMENTS
HOENDR (02 -97)
DIRECT BILL 0000 11187
003607
MEMO COPY
885303551
59
Policy No: HOF 0025224702 - 2
Company: NATIONWIDE INSURANCE COMPANY OF FLORIDA
DES MOINES IA (800) 282 -1446
Agency: JOHN PERRY INSURANCE AGENCY 59240
OKEECHOBEE FL
Insured: HARRELL, IDA B.
COVERAGES
DESCRIPTION
LIMIT
PREMIUM
IN2534 07/10
IN2526 08/08
1N2541 08/08
Inspection Form
Hurr Ded Option
ID Fraud Offer
HOENDR (02 -97)
DIRECT BILL 0000 11187
003607
MEMO COPY
885303551
59
12801 (08 -08)
ORDINANCE OR LAW COVERAGE OPTION
Important Information about Protecting Your Home
Dear Valued Customer,
Thank you for the opportunity to provide this Important Insurance protection. As your Insurance
provider, we like to keep you informed of new coverage options with your homeowners policy so
you may decide which coverage option is best for you.
In the event of a loss covered by the policy, Building Ordinance or Law provides coverage for the
increased costs you incur that result from any ordinance or law that regulates the construction,
use, repair or tearing down of the damaged property. This coverage includes the cost of
removing debris. The ordinance or law must have been in place during the policy period.
Your policy automatically provides Ordinance or Law coverage equal to 25% of the Coverage A
amount (or Building Additions and Alterations Coverage for Tenant policies) at no additional
premium charge.
You also have an option to elect an additional 25% coverage for a total of 50% of the Coverage A
Limit of Liability for Ordinance or Law.
The coverage limit you currently carry or Ordinance or Law is printed on your Declarations page.
Should you decide to increase or decrease your present coverage, please sign the form below
and return it in the enclosed envelope. If it is not returned to us, your previous selection printed
on your Declarations page will continue to apply.
If you have any questions regarding this Ordinance or Law coverage, please contact your
Nationwide Agent. We appreciate your immediate attention to this matter.
This notice does not provide coverage nor does it replace any provisions of your policy. You should read your policy and
review your Declarations page for complete information on the coverage you are provided. If there is any conflict between
policy, endorsements and this notice, the provisions of the policy or endorsements shall prevail.
If you choose to change your present Ordinance or Law coverage, please complete and
sign this form and return it in the enclosed envelope.
Selection of either percentage constitutes rejection of the other.
❑ I select the 25% Ordinance or Law coverage limit provided by this policy.
❑ I select the additional 25% coverage option for a total of 50% Ordinance or Law coverage.
Policyholder Signature Date
Policyholder Name
12801 (08 -08)
HOF 00252247022 07/06/11 003608 MEMO COPY 59
00 (L0-00) Nt090I
Nationwide "'
On Your Side -
NATIONWIDE INS CO OF FLORIDA
1100 LOCUST ST
DES MOINES IA 50391 -1100
(800) 282 -1446
AGENCY JOHN PERRY INSURANCE AGENCY
OKEECHOBEE FL
CONTINUATION DECLARATIONS
NAME INSURED AND ADDRESS
HARRELL, IDA B.
1706 SW 2ND AVE
OKEECHOBEE, FL 34974 -6186
The limit of liability for the structure (Coverage A) is based on the estimate of the cost to rebuild your home, including an approximate
cost for labor and materials in your area, and specific information that you have provided about your home.
HOMEOWNERS POLICY
POLICY NUMBER: HOF 0025224702 -1
ACCOUNT NUMBER: 885303551
Policy Period
From: 08 -28 -10 To: 08 -28 -11
12:01 A.M. Standard Time
Effective Date of Change
The described residence premises covered hereunder is located at the
above address, unless otherwise stated herein. (No., Street, City, State, Zip Code)
PREVIOUS POLICY NUMBER HOF 0025224702 -0
1706 SW 2ND AV
OKEECHOBEE, FL
34974 -6186
TO BE PAID BY NAMED INSURED
COVERAGE AND LIMITS OF LIABILITY
SECTION I
SECTION 11
A. DWELLING
B. OTHER
STRUCTURES
C. PERSONAL
PROPERTY
D. LOSS
OF USE
E. PERSONAL
LIABILITY
F. MEDICAL PAY
EACH PERSON
134,200
2,684
67,100
13,420
300,000
1,000
FOR LOSSES ARISING UNDER SECTION , WE WILL PAY ONLY THAT PART OF THE LOSS IN EXCESS OF $500,
EXCEPT FOR LOSS BY HURRICANE, FOR WHICH WE WILL PAY ONLY THAT PART OF THE LOSS
IN EXCESS OF 2% OF COVERAGE A.
COVERAGE
DESCRIPTION
PREMIUM
COVERAGES
DESCRIPTION
PREMIUM
BASIC COVERAGE
H03 01 /00
Special Form
1,029.98
12501S 08/08
ORD OR LAW
12501AS 08/08
SURCHARGES
12501HD 08/08
HURR DEDUCTIBLE
12501PC 08/08
PREM CHG INFO
H0277FL 08/08
Ord or Law - 50%
51.50
12669 08 /08
Back -up of Sewer
8.50
H048 01 /00
Oth Str lncr Lim
27.75
H070 01/00
Addl Res Rented
7.83
12559A 08/08
Per Prop Repl
154.50
12567F 08/08
Replacement Cost
4.27
16372 05/09
Sinkhole Collaps
18.79
12747 09/08
Biological Det
H0216 08/08
Prem Alarm Prot
10.44CR
HO300FL 09/08
Spec Provisions
IN2525 08/08
Opt Ded Offer
IN2532 08/08
Checklist of Cov
1N2537 08/08
.
Outline of Cov
IN2542 08/08
Hurr Mit Dsc Inf
H041 01/00
Add Ins Res Prem
12800 08/08
Hurricane Prov
IN0000F 05/09
Privacy Stmt
1N2526 08/08
Hurr Ded Option
IN2531 07 /10
FL Hurr Cat Fund
(CONTINUED)
TOTAL SURCHARGES
57.59
TOTAL ANNUAL
RENEWAL AMT DUE
1,350.27
Additional
Residence
Occupied
By Insured
Mortgage Loss Payee or Other Interest
Loan Number
4000509349/1
SEACOAST NATIONAL BANK
CITY OF OKEECHOBEE
STUART, FL
LANE GAMIOTEA
55 SE 3RD AVE
OKEECHOBEE, FL 34974 -2903
NATIONWIDE INS CO OF FLORIDA
Aiithnri7Ari R•nn.gt.ntativa
DIRECT BILL
0000 10187
MEMO COPY
T 885303551 59
00 (L0•0O) NL000J
Nationwide '
On Your Side-
NATIONWIDE INS CO OF FLORIDA
1100 LOCUST ST
DES MOINES IA 50391 -1100
(800) 282 -1446
AGENCY JOHN PERRY INSURANCE AGENCY
OKEECHOBEE FL
AMENDED DECLARATIONS
NAME INSURED AND ADDRESS
HARRELL, IDA B.
1706 SW 2ND AVE
OKEECHOBEE, FL 34974 -6186
The limit of liability for the structure (Coverage A) is based on the estimate of the cost to rebuild your home, including an approximate
cost for labor and materials in your area, and specific information that you have provided about your home.
HOMEOWNERS POLICY
POLICY NUMBER: HOF 0025224702 -0
ACCOUNT NUMBER: 885303551
Policy Period
From: 08 -28 -09 To: 08 -28 -10
12:01 A.M. Standard Time
Effective Date of Change
033010
COVERAGE
INFO
POLICY
MISC
INFO
POLICY
INFO
QUALIFIER
MISC
NON
INFO
INSURED
PERIL
INFO
PREMIUMS
SURCHARGE
MOUNTS
The described residence premises covered hereunder is located at the
above address, unless otherwise stated herein. (No , Street, City, State, Zip Code)
PREVIOUS POLICY NUMBER
HOF 0025224702 -0
1706 SW 2ND AV
OKEECHOBEE, FL
34974 -6186
TO BE PAID BY NAMED INSURED
C
SECTION I
SECTION II
A. DWELLING
B. OTHER
STRUCTURES
C. PERSONAL
PROPERTY
D. LOSS
OF USE
E. PERSONAL
LIABILITY
F. MEDICAL PAY
EACH PERSON
134,200
2,684
67,100
13,420
300,000
1,000
FOR LOSSES ARISING UNDER SECTION , WE WILL PAY ONLY THAT PART OF THE LOSS IN EXCESS OF $500,
EXCEPT FOR LOSS BY HURRICANE, FOR WHICH WE WILL PAY ONLY THAT PART OF THE LOSS
IN EXCESS OF 2% OF COVERAGE A.
COVERAGE
DESCRIPTION
PREMIUM
COVERAGES
DESCRIPTION
PREMIUM
BASIC COVERAGE
H03 01/00
Special Form
1,029.98
12501S 08/08
ORD OR LAW
12501AS 08/08
SURCHARGES
12501HD 08/08
HURR DEDUCTIBLE
H0277FL 08/08
Ord Q, Law C 50%
MEE
12669 08/08
Back -up of Sewer
8.50
H048 01/00
Oth Str Incr Lim
27.75
H070 01/00
Addl Res Rented
7.83
12559A 08/08
Per Prop Repl
154.50
12567F 08/08
Replacement Cost
4.27
16372 09/08
Sinkhole Collaps
18.79
12747 09/08
Biological Det
H0216 08/08
Prem Alarm Prot
10.44CR
HO300FL 09/08
Spec Provisions
IN0000F 07/08
Privacy Stmt
IN2525 08/08
Opt Ded Offer
IN2531 08/08
FL Hurr Cat Fund
IN2532 08/08
Checklist of Cov
IN2533 08/08
Loss Mitigation
IN2534 08/08
Inspection Form
IN2537 08/08
Outline of Cov
IN2540 08/08
Citizens Asmnt
IN2542 08/08
Hurr Mit Dsc Int
H041 01/00
Add Ins Res Prem
(CONTINUED)
TOTAL SURCHARGES
133.87
TOTAL ANNUAL
POLICY AMT DUE
1,426.55
Additional
Residence
Occupied
By Insured
NO ADDL PREMIUM
Mortgage Loss Payee or Other Interest
Loan Number
4000509349/1
SEACOAS NATIONAL BANK
CITY OF OKEECHOBEE
STUART, FL
LANE GAMIOTEA
55 SE 3RD AVE
OKEECHOBEE, FL 34974 -2903
NATIONWIDE INS CO OF FLORIDA
DIRECT BILL
I9Z9 10103
MEMO COPY
sentative
T 885303551 59
7532
23078000742047
77 09 HO 995226
Policy Number:
77 09 HO 995226
Issued:
JUN 22, 2009
ELITE POLICY
DECLARATIONS
Non - Assessable
Policyholder: Page 3 of 4
(Named Insured)
IDA HARRELL
Policy Period From:
AUG 28, 2008 TO AUG 28, 2009
OTHER COVERAGES /OPTIONS APPLICABLE
See Policy or Endorsements for details regarding the Other Coverages and Options that apply to your policy.
Other Coverages Limits of Liability
INFLATION PROTECTION
BOECKH INDEX 0732.8 APPL 1 ES
BIOLOGICAL DETERIORATION /DAMAGE CLEAN UP $ 10 , 000
FIRE DEPARTMENT SERVICE CHARGE
CREDIT CARD - FORGERY $ 1,000
Options Applicable
OPTION -I- EXTENDED REPLACEMENT COST APPL 1 ES
PERSONAL PROPERTY
OPTION -J- REPAIR COST PLUS APPL 1 ES
DWELLING
OPTION -L- PROTECTIVE DEVICE CREDIT APPL I ES
LOCAL FIRE OR SMOKE ALARM SYSTEMS
FIRE EXTINGUISHERS
DEADBOLT LOCKS ON ALL EXTERIOR ENTRYWAYS
WATER BACKUP
WATER BACKUP DEDUCTIBLE $500 APPLIES
ORDINANCE OR LAW 50% ON BUILDING, ADDITIONS, APPL I ES
AND ALTERATIONS
SPECIAL PROVISIONS
FL INS GUARANTY ASSOC /FL INS GUARANTY EMERGENCY $39.54
FLOHURRICANE IDA C T ENS REGULAR ASSESSMENT $24.33
FLORIDA CITIZENS EMERGENCY ASSESSMENT $21.30
FL INS GUARANTY ASSOC 2007 $30.42
PREMIUM SUMMARY
Premium Based On Premium Amount
POLICY PREMIUM
SINKHOLE COLLAPSE $ 1, 620.80
WATER BACKUP $ 12.00
Annual Premium $ 19.00
$ 1,651.80
Annual Premium Includes Discounts For:
HOME /CAR
HOME PROTECTIVE DEVICE
Annual Premium Includes Additional Charges For:
FL INSURANCE GUARANTY ASSOC ASSESSMENT /FL INSURANCE GUARANTY EMERGENCY ASSESSMENT
FLORIDA IC CAT FUND REGULAR ASSESSMENT
FLORIDA CITIZENS EMERGENCY ASSESSMENT
FLORIDA INSURANCE GUARANTY ASSOC 2007
19692000153046
77 09 HO 995226
Nationwide
Policy Number:
77 09 HO 995226
Issued:
FEB 13, 2008
ELITE POLICY
DECLARATIONS
Non- Assessable
Policyholder: Page 3 of 4
(Named Insured)
IDA HARRELL
Policy Period From:
AUG 28, 2007 TO AUG 28, 2008
OTHER COVERAGES /OPTIONS APPLICABLE
See Policy or Endorsements for details regarding the Other Coverages and Options that apply to your policy.
Other Coverages Limits of Liability
INFLATION PROTECTION APPL 1 ES
BOECKH INDEX 0720.6
BIOLOGICAL DETERIORATION /DAMAGE CLEAN UP $ 10, 000
FIRE DEPARTMENT SERVICE CHARGE $ 500
CREDIT CARD - FORGERY $ 1,000
Options Applicable
OPTION -I- EXTENDED REPLACEMENT COST APPL I ES
PERSONAL PROPERTY
OPTION -J- REPAIR COST PLUS APPL I ES
DWELLING
OPTION-L-PROTECTIVE LOCAL FIRE OR SMOKE AILARM SYSTEMS APPLIES
FIRE EXTINGUISHERS
DEADBOLT LOCKS ON ALL EXTERIOR ENTRYWAYS
WATER BACKUP
WATER BACKUP DEDUCTIBLE $500 APPLIES
ORDINANCE OR LAW 50% ON BUILDING, ADDITIONS, APPL I ES
AND ALTERATIONS
SPECIAL PROVISIONS
FL INS GUARANTY ASSOC /FL INS GUARANTY EMERGE NCY
FLORIDA IC CITIZENS REGULAR ASSESSMENT
FLORIDA CITIZENS EMERGENCY ASSESSMENT26.70
$23.37
PREMIUM SUMMARY
$43.39
Premium Based On Premium Amount
POLICY PREMIUM $ 1 , 760.15
WATER BACKUP $ 19.00
Annual Premium $ 1,779.15
Annual Premium Includes Discounts For:
HOME /CAR
HOME PROTECTIVE DEVICE
Annual Premium Includes Additional Charges For:
FL INSURANCE GUARANTY ASSOC ASSESSMENT /FL INSURANCE GUARANTY EMERGENCY ASSESSMENT
FLORIDAIC CITIZENS ENS R GULAR ASSESSMENT
FLORIDA CITIZENS EMERGENCY ASSESSMENT
02/11/2008 18:51 18637630031
IIITE POLICY: 77H0995 -226
].ST MORTGAGEE AND ADDRESS
SEACOAST NATL BANK
ISAOA ATIMA
PO BOX 9012
STUART
FL 34995 -9012
PERRY REDISH AGENCY PAGE 02
NATIONWIDE INSURANCE COMPANY OF FLORIDA MEMORANDUM OF INSURANCE
PAGE 1 OF 1
NON- ASSESSABLE POLICY PERIOD BEGINS 12:01 AM
POLICY PEKIUD-- -• INCEPTION 8-28-07 STANDARD TIME AT THE
EXPIRATION 8 -28-08 RESIDENCE PREMISES.
NAMED INSURED AND ADDRESS 11 LOCATION OF DESCRIBED PROPERTY
IDA HARRELL 1706 SW 2N0 AV
1706 SW 2ND AV OKEECHOBEE
FL 34974 -6186
OKEECHOBEE
FL 34974-61$6/
LOAN NO. 935554 * * ***TO REPORT CLAIMS, CALL 1- 800-421-3535
ADDITIONAL INSURED
CITY OF OKEECHOBEE
LANE GAMIOTF..
55 SE 3R0 AVE
OKEECHOBEE
FL 34974-0000
1 IMPORTANT NOTICE
i This Memorandum of Insurance provides basic information regarding coverage, premium and interests protected by
your policy as of 2-11 -08. A formal Declarations page superseding this Memorandum will be mailed which will
J provide complete updated coverages and premium details_
SECTION I COVERAGES LIMIT
A- DWELLING $124,500
B-01HER STRUCTURES $9,428
C. PERSONAL PROPERTY $62,250
0 LOSS OF USE $12.450
SECTION II COVERAGES
E-PERSONAL LIABILITY
PD /BI -EA OCCURRENCE
F-MEDICAL PAYMENTS
TO OTHERS -EA PERSON
OTHER COVERAGES
-BIOLOGICAL. DETR /DAMAGE CLEAN UP
-FIRE DEPT. SERV. CHARGES
- CREDIT CARD-FORGERY
AND ELEC. FUNDS TRANS.
$300,000
31.000
LIMIT
$10.000
5500
$1,000
I)I:OUCTIDLE- SECTION I (IN CASE OF A LOSS
UNDER SECTION I, WE COVER ONLY THAT PART
Of THE LOSS OVER THE DEDUCTIBLE STATED).
ALL PERILS $ 500 HURRICANE DED 2%
Receipt of payment is hereby acknowledged.
received subject to collection only.
PREMIUM EXCLUDING TAXES 31,669.00
COUNTERSIGNATURE DATE: 2-11 -08
SPECIAL LIMITS OF LIABILITY
SEE POLICY
SECTION II EXCEPTIONS: The residence
owned or held for rental by the named
business property. and is used solely
purposes. Exceptions, if any:
ADDL DWG UNITS RENTED OR HELD FOR
ADDITIONAL COVERAGE OPTIONS
OPTION LIMIT
I -EXT. REPL. COST APPLIES
J- REPAIR COST PLUS APPLIES
L- PROTECT. DEVICE APPLIES
0 -ORD OR LAW -50% OF COV-A
WATER BACKUP APPLIES
premises is the only premises
insured or spouse, other than
for private residential
RENTAL -1
SPECIAL PROVISIONS (Applicable only if indicated):
INFLATION PROTECTION COVERAGE IS INCLUDED.
Balance, If any, will be billed by the company. Checks and drafts are
NT NAME A 7 N0. JOHN C. PERRY
STATE FFARM
lam)
MAO
INSURANCE
FIRE POLICY STATUS
MC GUSHION, SHAUN D & LISA M
PO BOX 732
OKEECHOBEE FL 34973 -0732
TYPE: HOMEOWNER EXTRA
PREMIUM: 314.00
COVERAGE INFORMATION
A- DWELLING 64200
DWELL EXT 6420
B -PERS PROP 48150
C -LOSS USE ACT LOSS
L -PERS LIAB 100000
DMG TO PROP 500
M- MED /PERS 5000
POLICY NO:
LOCATION:
DISCOUNT:
JUNE 28, 1994
H PH. (813)763 -8506 I
59- E6- 2970 -6 F YR I
1706 SW 2ND AVE
OKEECHOBEE FL
HA INCL/ 5%REN$ 14
NSP: NOV -93
SSD: 90
34974 -6186
TERM: CONT AMOUNT PAID: 314.00
RENEW DATE: JAN -19 -95 DATE PAID: JAN -19 -94
BILL TO: MTG
PREV. RISK:
PREV. PREM:
CONST: FRAME
ZONE: 97
PROT. CLASS: 6
YR BLT: 87
FAMILIES: 01
DEDUCTIBLES APPLIED: 500 ALL PER
MESSAGES:
* MORTGAGEE
BARNETT MORTGAGE COMPANY
ITS SUCCESSORS AND /OR ASSIGNS
P 0 BOX 2029
JACKSONVILLE FL 32203 -2029
LOAN NO: 612193
ACCOUNTING INFORMATION: FL EMPA
61,200
257
HA: FE DB SA
2.00
FORMS
FP -7925
FE- 7442.3
FE -7589
FE- 7210.4
AND ENDORSEMENTS
EXTRA FORM
DRAIN BACK -UP
EXTRA REPLACE
AMENDATORY END