Tower Homeowner Fax-A-Quote ( ) Please attach ACORD Homeowner form or a copy of your FSC quote
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1 303 Lennn Lane Walnut Creek, CA (800) (925) Fax (925) License# Twer Hmewner Fax-A-Qute ( ) Please attach ACORD Hmewner frm r a cpy f yur FSC qute Agency Name & Cntact: Agency Phne Number: Agency Cntact Agency Fax Number: Credits/Surcharges: 1. Prpsed effective date? 2. Number f families: Single Duplex Triplex Furplex 3. Number f stries: 4. Garage type: Nne 1 Car 2 Car 3 Car 5. Primary Heat Surce: Gas Oil Other 6. Des yur agency write the insured s aut plicy (regardless f carrier)? Yes N Carrier: Plicy #: Eff. Date: 7. Prtective devises: Gated Cmmunity Neighbrhd Watch Autmatic Sprinklers Alarm cmpany name: Alarm Cmpany Accunt Number: 8. Age f lan: 0-12 mnths mnths 24+ mnths Optinal Endrsements: 9. *Prtectin Plus Endrsement: Yes N 10. *Prtectin Superir Endrsement: Yes N millin persnal liability cverage: Yes N 12. All Risk Cntents/HO5 Endrsement: Yes N 13. Ordinance & Law (100%): Yes N 14. Additinal residences rented t thers: Yes N 15. Other lcatins ccupied by insured: Yes N 16. Scheduled Persnal Prperty (list items and values): Yes N 17. Identity Theft: Yes N 18. Wrkers Cmp Residence Emplyees: # f Inservants # f Outservants 19. Accidental Freeway Death: Yes N 20. Mrtgage Payment Prtectin: Yes N 21. Equipment Breakdwn Cverage: Yes N * If the hme was built after 1950, is mre than 500 ft. frm brush, and has nt had incurred a lss in the last three years it will qualify fr the Preferred r Elite Tier. If this is the case yu must select either the Prtectin Plus r the Prtectin Plus Superir Endrsement. See the next page fr Endrsement details. Fax t ( )
2 303 Lennn Lane Walnut Creek, CA (800) (925) Fax (925) License# Prtectin Plus - $38 A. Unscheduled Jewelry, Watches and Furs - All Risk Cverage B. Special Limits f Liability fr Cv. C increased as fllws: 1. $2,000 n securities, accunts, etc. 2. $2,500 n watercraft, including their trailers etc. 3. $2,500 n trailers nt used with watercraft. 4. Special Limits n grave markers has been deleted. 5. $2,500 fr lss by theft, misplacing, r lsing f jewelry, watches, and furs. 6. $5,000 fr lss by theft f silverware. 7. $1,000 fr lss t adaptable electrnic apparatus while in a mtr vehicle 8. $1,000 fr lss t adaptable electrnic apparatus away 9. $10,000 fr lss by theft f jewelry, watches, furs, precius and semi-precius stnes and silverware, etc. while n premises f any bank, trust cmpany, safety depsit cmpany r cld strage warehuse in which the prperty has been placed fr safekeeping. C. Cv D - Lss f Use has been extended t cver pwer interruptin caused by an insured peril which makes the residence premises uninhabitable and bradens lss f use cverage prvided when a civil authrity prhibits the use f the residence premises. D. Fire department service charge includes cverage fr prperty inside recgnized fire districts. E. Refrigerated prducts cverage up t $500. F. Credit card and bank fund transfer cverage up t $2,500. G. Bradened tree debris remval cverage. H. Persnal Injury cverage up t the Cv. E limit. I. Additinal Sectin II cverage - $100,000 fr Cv E and $1,000 fr Cv F. J. Outbard, Inbard r Inbard-Outdrive mtr extensin f cverage is prvided fr wned utbard, inbard r inbard-utdrive bats up t 50 hrsepwer. K. $2,000 in Persnal Prperty Cverage extensin fr prperty away frm premises fr damage caused by fld, earthquake r landslide. L. $250 Lck Replacement cverage. M. Damage t the Prperty f Others limit is increased t $1,000. N. Prperty Damage t prperty f thers in the cntrl f the insured has been bradened t include water damage related perils. O. Claim Expenses limit has been increased frm $50 a day t $100 a day. Prtectin Plus Superir - $92 Identical t Prtectin Plus Endrsement but sectin B cverages listed abve are changed t the fllwing limits and cverages. B. Special Limits f Liability fr Cv. C increased as fllws: 1. $5,000 n securities, accunts, etc. 2. $2,500 n watercraft, including their trailers etc. 3. $2,500 n trailers nt used with watercraft. 4. Special Limits n grave markers has been deleted. 5. $5,000 fr lss by theft, misplacing, r lsing f jewelry, watches, and furs. 6. $10,000 fr lss by theft f silverware. 7. $1,000 fr lss t adaptable electrnic apparatus while in a mtr vehicle 8. $1,000 fr lss t adaptable electrnic apparatus away 9. $50,000 fr lss by theft f jewelry, watches, furs, precius and semi-precius stnes and silverware, etc. while n premises f any bank, trust cmpany, safety depsit cmpany r cld strage warehuse in which the prperty has been placed fr safekeeping. 10. $5,000 n theft f firearms. 11. $5,000 n business prperty n premises. 12. $1,000 n business prperty ff premises.
3 ELIGIBILITY One family, wner-ccupied primary residence One r tw family wner ccupied primary residence One t fur family wner ccupied primary residence BRUSH Nt eligible within 500 feet f a designated brush zne. MUDSLIDE Nt eligible when insured lcatin is built n a slpe f 30 degrees r mre. WIND Nt eligible when insured lcatin is within 1000 feet f tidal water. SUSPENSION OF BINDING AUTHORITY CAT MANAGEMENT Binding authrity is autmatically suspended whenever a designated hurricane r trpical strm warning is psted by the Natinal Weather Service (NWS). Binding may begin when the all clear is given by the NWS. Binding authrity will be suspended when an earthquake ccurs registering at least 5.0 n the Richter scale. The binding suspensin will be in effect up t 150 miles frm the epicenter and last fr 30 days frm the date f the event. Any aftershck measuring at least 5.0 will reactivate the 30 day suspensin, effective the date f the aftershck. The cmpany will advise if the suspensin is lifted prir t the 30 day mratrium. The cmpany may impse temprary binding restrictins in the event f ther natural disasters such as wildfires and mudslides. The cmpany may establish temprary r permanent binding restrictins in rder t cntrl and maintain apprpriate levels f expsure within a specific gegraphic regin. Page 1 f 4
4 AGE OF DWELLING HO3/HO5: 1990 r newer HO6: 1980 r newer HO3: 1970 r newer HO6: 1980 r newer HO3: 1920 r newer HO6: 1980 r newer Heating/plumbing systems updated in the last 20 years. Update frm signed by the insured must be cmpleted and signed by the insured and kept in the agent s ffice. UPDATES/MAINTENANCE Electrical service must be able t handle all current utilities. Hmes withut circuit breakers, with aluminum r mixed wiring r with knb and tube wiring cannt be bund. Rf, sidewalks and remainder f dwelling, must be maintained and in gd repair. FORMS HO3, HO5 and HO6 HO3/HO5 autmatically includes Platinum Plus Endrsement HO3, HO4, HO5 and HO6 HO3/HO5 Dwelling Cverage HO3/HO5 Dwelling Cverage HO3/HO5 Dwelling Cverage COVERAGE MINIMUMS AND MAXIMUMS Minimum: $300 K Maximum: $1,000,000 Minimum: $250 K Maximum: $800 K Minimum: $150 K Maximum: $800 K MINIMUM DEDUCTIBLE $500 PROTECTION CLASS PC 1-8 (There must be a hydrant within 1000 feet f the dwelling.) PC 1-9 INSURANCE-TO-VALUE 100% REPLACEMENT COST Page 2 f 4
5 LOSS HISTORY N claims in last 3 years. N claims in last 3 years. One prperty lss than $10,000 in last 3 years. PRIOR INSURANCE Risk must nt have been canceled, declined r nn-renewed fr underwriting reasns r had either a histry f nn-payment r a gap in cverage with the prir insurer. Maximum: Maximums: Maximums: SCHEDULED PERSONAL PROPERTY (JEWELRY AND FURS ONLY) $20,000 per item $100,000 per schedule Appraisals: Evidence f value required- appraisal r bill f sale n lder than 3 years ld must accmpany submissin. $15,000 per item $60,000 per schedule Appraisals: Evidence f value required appraisal r bill f sale n lder than 3 years ld must accmpany submissin. $10,000 per item $50,000 per schedule Appraisals: Evidence f value required- appraisal r bill f sale n lder than 3 years ld must accmpany submissin Page 3 f 4
6 Any risks with the fllwing may nt be written: UNACCEPTABLE S Any business cnducted n premises (except permitted incidental ccupancies). Any day care peratin is prhibited. Dwellings in the curse f cnstructin r renvatin. Dwellings with a wd rf must be lcated mre than 3 miles frm a brush fire area. Vacant r unccupied dwellings r adjacent structures. Mbile hmes r trailers. Mdular hmes nt n a permanent fundatin. Hmes withut central heat. Hmes with undergrund il strage tanks. Hmes with extrardinary liability hazards t include but nt limited t tramplines, skatebard ramps. Swimming pls nt cnfrming t lcal rdinances, r nt prtected by a lcked fence. Risks that have been canceled, declined r nn-renewed fr underwriting reasns. Pit Bulls, Rttweilers, Akitas, German Shepherds r any animal with a bite histry r cnsidered vicius as develped n Inspectin Hmes with prtable space heaters f any kind. This includes gas n gas. Wd burning stves must be prfessinally installed t cnfrm t all applicable building and fire cdes. Permanently installed space heaters are acceptable as fllws: they must be less than 15 years ld, installed by a licensed prfessinal, acceptable pwer surce can be electric r gas (lp fuel is nt acceptable), a 36 inch buffer is required frm any cmbustible material, and the unit must be UL apprved, have n pen element r flame surce, and prper ventilatin. Frame rw dwellings built befre Seasnal/secndary dwellings require primary supprt and underwriting apprval prir t submissin. N rental expsure allwed. N mre than 2 mrtgagees Dwellings that are in r pending freclsure are ineligible.. Farming, including incidental farming is excluded. Risks in the name f a Crpratin, LLC, Trust, Estate as named r additinal insured. Cnd r Hmewners Assciatin as additinal insured is ineligible. Dwellings with expiring cverage written thrugh a surplus lines carrier. Page 4 f 4
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