Policy Summary

lAPPLICATION NUMBER RIN1717811

AMERICAN BANKERS INSURANCE COMPANY OF FLORIDA
11222 Quail Roost Drive, Miami, FL 33157 -6596 (305) 253-2244
RENTERS INSURANCE APPLICATION
Applicant's Name
Requested Coverage Effective Date
Robel Regassa
2012-07-22
Applicant's Insured Address and Unit/Apartment Number, City, State, ZIP Code
9332 EDMONSTON RD 104, GREENBELT, MD 20770
Mailing Address (if different from insured address), City, State, ZIP Code
Applicant's Phone Number (571)314-0227
Construction Type: N/A

E-Mail Address robel.regassa@gmail.com
Type of Dwelling: Apartment/Condominium

Interested Party Name
N/A
Interested Party Address
N/A
PERSONAL PROPERTY COVERAGE
State: MD

$5,000 Personal Property Coverage

Replacement Cost Coverage INCLUDED.
Sewer or Drain Backup Coverage NOT INCLUDED.

Term of Coverage: 1 YEAR.
PAYMENT METHOD
Credit Card

Visa

XXXXXXXXXXXX4314
02/2015
Payment Plan Option: 8
1 Initial Payment of $14.56
7 Installment Payments: $14.92
A $15 policy fee, if applicable, is included in your premium.
Payment Plan Options are available to all Payment Methods. If installment payment plan is chosen, a $4.00
service fee is included in each installment. The service fee of $4.00 is not applicable to the initial payment.
In addition to Personal Property Coverage, I understand the plan includes $100,000 Personal Liability, $500
Medical Payments per Person to Others, $500 Property Dama ge to Others, and a $250 deductible will be applied
to Personal Property Coverage under all plans. This policy provides only limited coverage for certain classes of
property.
By typing my full name below as it appears on my account to be billed, I req uest enrollment in Renters Insurance
and authorize the billing of the cost of the insurance to my account to be billed. I agree to the use of electronic
enrollment and intend the use of the electronic signature that follows to evidence my consent of this e nrollment.
I consent to entering...