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FLOOD POLICY DECLARATIONS AMERICAN BANKERS INSURANCE COMPANY OF FLORIDA

ISSUE. DATE: NAMED INSURED AND MAILING ADDRESS AGENTS NAME AND ADDRESS AMERIFLOO LLC 4613 LITTLE ROAD TRINITY. FL 34655-0000

NO:

POLICY TERM: 1 YEAR(S)

INCEPTION:

EXPIRATION:

THESE DECLARATIONS ARE EFFECTIVE 12:D1 AM LOCAL TIME AT THE DESCRIBED LOCATION COVERED BY THIS POLICY LOCATED AT THE ABOVE MAILING ADDRESS, UNLESS OTHERWISE STATED BELOW.

RATING INFORMATION
CONSTRUCTION DATE: BUILDING DESCRIPTION: NO.OF FLOORS:
BASEMENT DESCRIPTION:

COMMUNITY NAME: COMMUNITY NO PROGRAM STATUS: CONDO TYPE: COMMUNITY RATING: RISK ZONE: NO_OF UNITS: ELEVATED BUILDING: RATING ELEVATION: BUILDINGS CONTENTS

CONTENTS LOCATION: LOWEST FLOOR ELEVATION: LIMITS OF LIABILITY BUILDINGS CONTENTS BASIC BASE FLOOD ELEVATION: DEDUCTIBLE AMOUNTS

RATES AND AMOUNT OF INSURANCE IN FORCE FOR BUILDING AND CONTENTS


TYPE OF COVERAGE BUILDINGS CONTENTS FIRST MORTGAGEE NAME AND ADDRESS LOAN NO. PREMIUM SUBTOTAL CRS DISCOUNT EXPENSE CONSTANT FEDERAL POLICY FEE COVERAGE 0 (ICC) TOTAL PREMIUM AMT_OF INS. RATE PREMIUM AMT.OF INS_ ADDITIONAL RATE DEDUCTIBLE PREMIUM BUYBACK'D ISC_ T O T AL PREMIUM

OTHER PAYOR NAME AND ADDRESS

LOAN NO.

AGENCY NO 1A65001FLO

PRODUCER NO 0000000000

AGENT PHONE NO_ (800)263-7435

P AYO R INSURED

COUNTER SIGNATURE