1477 Butler St Flood Insurance QuoteJun:21. 2012 12:02PM P & C Insurance Specialists No,3329 P. 2
w .. Policy Nur" "T= $704�4
TRAVELERS FLOOD POLICY DECLARATIONS
Vie standard Fire Insurance Company
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Type: New Business
Policy Period: o4/46/2012 04/06/2013
Form- swelling
Producer Name and Mailing Address:
TNT INSURANCE INC,
1245 GOLDEN GATE DR
PAPILLION, NE 68046
Agent/Agwy #: OCRW9
Reference #:1016 3 -1554 7 -000
Phone *: (402)885.8797
Iusured Property, Address-
1477 SUTLER ST
BLAIR, NE 68009
Premium Payor: 1st Mortgagee
Rated Zone: AE Current. Zone:
Community Number: 31 0226 0167 D
Community Name: BLAIR, CITY OF
Grandfathered: No
PfgS -Firm Construction
Program Type: Regular
For payment statue, call: (888) 245 -7274
These Aeclarationt are effective
ae of-. 04/06/2012 at 12:01 AN
Insured Name and Mailing Address:
(redacted)
Processed by:
Flood Serviea Center
P.d, Box 7775 Kalispell MT 59904-7775
Coverage Limitations May Apply, Rofer to Your
Flood Insurance Policy for Details.
Building Description:
Single. Family
Two Floors
Basement
Main House /Building
Primary Residence.
Replacement Cos
Number of Units: 1
�I 13.00 t9 v 1Y]8t�;;' I:nl 913.00
144,000 _410 9 5,644 17
.4- B ,���R„ �L. „';•::'::;;,:,,:;......; 1
l�y;gS77titill :i ^ ' 70.00
Basement
and Ab
ove --
Ufa �az>aent
mi3F''k1 nem 'tiri ls),Li 1,023,Q0
First Mortgage:
FIRST NATIONAL BANK OF OMAHA.
ISAOA
1620 DODGE ST STOP 3166
OMAHA, NE 68197 -0003
Loan : 531566
Second Mortgage:
.J
i
Third Mortgage:
Fourth Mortgage:
Your Insurer is The Standard Fire Insurance Company, One Tower Square, Hartford, CT 06183
For information about how Travelers compensates independent agent and brokers, please visit www.Travelers,com
or call our toll free telephone number 1- 666 -904- 8348, You may also request a written copy from Marketing at
One Tower Square, 2GSA, Hartford, Connecticut 06183
TRvnFr. Arm �N n:sp 000003771056
Jun, 21. 2012 12:02PM
THE STANDARD FIRE INSURANCE COMPANY
FLOOD SERVICE CENTER
P.D. Box 7775
Kalispell, MT 599044775
Telephone: (800)356 -6670
On Renewal Bill To: First Mortgagee
m Policy Type: Standard
Waiting Feriod: Lender Required - No Walt ($FHA)
Loan Close Date:
2 Prior Policy Number:
Prior Policy Expiration Date:
Prior Policy Issued By:
Current Community Number: 310228 0167 D
� 8
Regular
Q Current Flood Zone:
z
d
GLAIR, NE 68008 -2208
Tnt Insurance Inc
Telephone: (402)4262976
Agent Address:
Email:
w
1477 BUTLER 5T
O. p
Building Description:
a ° q
BLAIR, NE 68008 -2208
On Renewal Bill To: First Mortgagee
m Policy Type: Standard
Waiting Feriod: Lender Required - No Walt ($FHA)
Loan Close Date:
2 Prior Policy Number:
Prior Policy Expiration Date:
Prior Policy Issued By:
Current Community Number: 310228 0167 D
>� FIRM Date:
7- 16.1981
z Program Type:
Regular
County:
WASHINGTON COUNTY
Q Current Flood Zone:
AE
Current BFC:
Tnt Insurance Inc
Flood Zone Det Number:
Agent Address:
occupancy:
Single Family
Building use
Main House /Building
Building Description:
Primary Residence
Papillion, NE 48046.0000
COVERAGE BASIC LIMITS
Foundation:
Basement / Un•Finished
a
Number of Floors:
Two Floors
W Condo Form of Ownership:
No
Number of Units:
0
Condo Description:
Not a Condo
Location of Contents:
$5,000 $0
P & C Insurance Specialists
No, 3329 P, 3
STANDARD FLOOD INSURANCE APPLICATION
QUOTE NUMBER: 7363652
POLICY NUMBER:
ALTERNATE POLICY NUMBER.
REQUESTED EFFECTIVE DATE: 4-6 -2012 to 4. 6.2013
12 :01 a.m, local time at the insured property location
FIRST NATIONAL BANK OF OMAHA
LL ISAOA
1620 DODGE ST STOP 3166
w
E OMAHA, NE 68147.0003
Loan Humber: 531586
Additional Mortgagee Info on Application Part 2, if applicable.
Grandfathered: No Grandfathering
Grandfathered Community Number:
Grandfathered Flood Zone:
Date of Construction Source: Original Construction Date
Date of Construction:
Agent Name:
Tnt Insurance Inc
Building Walled a Roofed:
Producer Number
10163.15547. 000 -00001
Not over Water
Alternate Agent Number: OCRM39
No
Agenty Name:
Tnt Insurance Inc
Estimated Replacement Cost:
Agent Address:
1205 Golden Gate Or
100%
Top of Bottom Floor Elevation:
Attached Garage Elevation:
Papillion, NE 48046.0000
COVERAGE BASIC LIMITS
Phone Number:
(402)885.6797
FIRST NATIONAL BANK OF OMAHA
LL ISAOA
1620 DODGE ST STOP 3166
w
E OMAHA, NE 68147.0003
Loan Humber: 531586
Additional Mortgagee Info on Application Part 2, if applicable.
Grandfathered: No Grandfathering
Grandfathered Community Number:
Grandfathered Flood Zone:
Date of Construction Source: Original Construction Date
Date of Construction:
1-1.1956
Building in Course of Construction: No
Building Walled a Roofed:
0 Date photos Taken:
Building Dyer Water:
Not over Water
Located on Federal Land:
No
Principal Residence:
Yes
Estimated Replacement Cost:
$122,000
Replacement Cost Ratio:
100%
D Building Floodproofed:
S Elevation Certificate Date!
Base Flood Elevation:
Lowest Floor Elevation:
Lowe3tFlo6r Base Flood =
Elevation Difference
0 Date photos Taken:
Next Higher Floor Elevation:
1= Building Diagram plumber:
Lowest Adjacent Grade:
} Floodproofed Elevation:
Highest Adjacent Grade:
Top of Bottom Floor Elevation:
Attached Garage Elevation:
COVERAGE BASIC LIMITS
ADDITIONAL LIMITS
DEDUCTIBLE PREMIUM CALCULATIONS 1
FOR AMOUNT RA TE PREMIUM AMOUNT RATE PREMIUM
AMOUNT DEDUCTIBLE
TOTAL TOTAL ANNUAL
DECREASE
AMOUNT PREMIUM
1 Building $60,000 0181
$486 $62,000 0,97 $601
$5,000 $0
5122,000 $1,087
Contents $0 0.00
$o 50 0100 $0
$0 $0
$0 $0
,4 ^_ DEDUCTIBLE OPTIONS
Annual Subtotal:
S1 ,0871
BUILDING
( CONTENTS
PREMIUM 1
ICC Premium:
570
I $1,000
i so
$1,279
S.b Total:
$1,1571
1 52,000 1 $o
$1,197
I CRS Discount: 0%
$01
L $3,000
$0
$1,137 1
1Polky Fee:
1 $401
i $4,000
$o
$1 1
(Probation Surcharge!
$01
i $5,000
$0
$1,023 1
ITatal Premium:
, $1,0231
FULL PREMIUM
MUST ACCOMPANY APPLICATION
i eRF4 e 911tairieu nerein are correct to the best of my knowledge. The property owner and
I understand that any false statements may be punishable by fine or
impf onment under ble federal law-
3-27-201Z
Signature of A$en oducer
Date
Signature of Insured (Optional)
Date
FP v10.l A2.5
Page 1 of 3
Printed By :tntlns09
Print Date: 3.27.2012