DATE(MM/DD/YYYY)

EVIDENCE OF PERSONAL PROPERTY INSURANCE 02/15/2022

THIS EVIDENCE OF PROPERTY INSURANCE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE
ADDITIONAL INTEREST NAMED BELOW. THIS EVIDENCE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE
COVERAGE AFFORDED BY THE POLICIES BELOW. THIS EVIDENCE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE
ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE ADDITIONAL INTEREST.
AGENCY PHONE (A/C, No, (800)566-1186 COMPANY
Ext):

PEAK INS ADV, LLC/RES SHIELD - PEAK Praetorian Insurance Company

8616 FREEPORT PKWY One QBE Way
IRVING, TX 75063 Sun Prairie, WI 53596
FAX (855)268-9561 E_MAIL none@email.com
(A/C,No): ADDRES Please remit payment, including policy number, to:
S:
CODE: PEAK SUBCOD QBE
E:
PO Box 734576
AGENCY MA15466220
CUSTOMER ID #:
Chicago IL 60673-4576

INSURED LOAN NUMBER POLICY NUMBER

PRH6024973
JAMILE A DEOLIVEIRA EFFECTIVE DATE EXPIRATION DATE CONTINUED UNTIL
1630 WORCESTER RD 02/20/2022 02/20/2023 X TERMINATED IF CHECKED
201 THIS REPLACES PRIOR EVIDENCE DATED:
FRAMINGHAM, MA 01702

PROPERTY INFORMATION
LOCATION/DESCRIPTION

Location 001 - 1630 WORCESTER RD APT 201, FRAMINGHAM, MA, 01702

1630 WORCESTER RD APT 201
FRAMINGHAM, MA 01702

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
EVIDENCE OF PROPERTY INSURANCE 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.
COVERAGE INFORMATION
COVERAGE/PERIL/FORMS AMOUNT OF INSURANCE DEDUCTIBLE
C - Personal Property $10,000 $500 Theft;$250-All Oth Perils
WH $1,000
D - Loss of Use $2,000
E - Personal Liability (Limit) $100,000
F - Medical Payments (Limit) $1,000

REMARKS (Including Special Conditions)

TOTAL PREMIUM: $270.00

CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE
DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS.
ADDITIONAL INTEREST
NAME AND ADDRESS X PM
LOAN #
HALSTEAD FRAMINGHAM - GREYSTAR
AUTHORIZED REPRESENTATIVE
PO BOX 115009
CARROLLTON TX 75011-5009

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