Homeowners Policy#: OA4481641

Customer Information Agent Information

JAYSEN JOHNSON PROVENCE FINANCIAL &
LAURA JOHNSON 19553 PARTHENIA ST STE 1A
40415 JENNINGS DR NORTHRIDGE, CA 91324-3415
MURRIETA, CA 92562-4821
Phone Number: (866) 472-3326
Date Prepared: 06/26/2020 Email: janeece.goforth@provenceinc.com
Website: www.provenceinc.com
Policy Period: 01/10/2020 to 01/10/2021
Agent #: 163238
Changes Effective: 06/26/2020

PREMIUM SUMMARY Premium

Primary Coverages - New Quality Plus $1,477.00
Other and Optional Coverages $47.00
Discounts and Surcharges -$276.85
Your total policy premium for 12 months is $1,247.15

DWELLING LOCATION
40415 JENNINGS DR
MURRIETA, CA 92562-4821

PRIMARY COVERAGES
Additional Living
Dwelling Other Structures Personal Property Personal Liability Medical Payments
Expenses
$568,800 $56,880 $284,400 $113,760 $300,000 $1,000

DEDUCTIBLES Amount
All Perils Deductible $2,500.00

This is not a contract but confirms that the coverages displayed are in effect.

OTHER AND OPTIONAL COVERAGES Limit Premium

Extended Dwelling Coverage 50% Included
Personal Property Replacement Cost Included
Personal Offense $8.00
Building Ordinance or Law Coverage 10% Included
Sewer & Water Back-Up for Bldg & Contents 5,000 $39.00
General Insurance Company of America
 Homeowners Policy#: OA4481641

Loss Assessment 3,000 Included

Worker's Comp - Occasional Employees Included
__________
Total $47.00
DISCOUNTS AND SURCHARGES Premium
Account Credit
New Buyer Discount
License, Tax or Fee:
California Seismic Safety Fee $0.15
__________
Total -$276.85

Coverages: Insurance is afforded only for such coverages as are indicated by specific premium charges.

ADDITIONAL INTERESTS

Name: UNITED WHOLESALE MORTGAGE Interest Type: Mortgage Servicing Agency for 1st Mortgagee
Its Successors And/Or Assigns Loan Number: 1220359269
po box 202028
florence, SC 29502-2028

General Insurance Company of America

 Homeowners Policy#: OA4481641

EVIDENCE OF INSURANCE FOR MORTGAGE COMPANIES

Customer Information Agent Information
JAYSEN JOHNSON PROVENCE FINANCIAL &
LAURA JOHNSON 19553 PARTHENIA ST STE 1A
40415 JENNINGS DR NORTHRIDGE, CA 91324-3415
MURRIETA, CA 92562-4821
Phone Number: (818) 700-1494
Date Prepared: 06/26/2020 Email: janeece.goforth@provenceinc.com
Policy Period: 01/10/2020 to 01/10/2021 Website: www.provenceinc.com
Changes Effective: 06/26/2020 Agent #: 163238

Mortgagee(s)
UNITED WHOLESALE MORTGAGE
Its Successors And/Or Assigns
po box 202028
florence, SC 29502-2028
Loan Number: 1220359269

DWELLING LOCATION DWELLING LIMIT: $568,800

40415 JENNINGS DR Extended Dwelling Coverage Limit: Up to 50%
MURRIETA, CA 92562-4821
POLICY PREMIUM: $1,247.15 DEDUCTIBLES
BALANCE REMAINING: ____________________ Section I - Property Coverages $2,500

MAKE CHECK PAYABLE TO: Safeco Insurance

MAIL PAYMENT TO:

Safeco Insurance
Attn: Payment Processing Operations
PO Box 91016
Chicago, IL 60680-1016
This is not an insurance policy and does not amend, alter or extend the coverage afforded by the policy listed.
Coverage does not include earthquake or flood.

Agent Signature: _________________________________

<SF.AR.S>

General Insurance Company of America