Homeowners Proposal of Insurance for...Insurance Berkshire Hathaway GUARD Insurance Companies...
Transcript of Homeowners Proposal of Insurance for...Insurance Berkshire Hathaway GUARD Insurance Companies...
Total Estimated Premium:
Effective Date: thru
Proposal Number:
Payment Terms:
Proposal of Insurance for . . .
Presented by
August 2017 Edition
Homeowners
Berkshire Hathaway
GUARD Insurance
Companies specialize
in providing
Property & Casualty
insurance coverage.
Nancy Burklow3548 Sherman St
Springfield, IL 62703-4855
$560.00
06/04/2019 06/04/2020
NAHO080789
20% down payment, 11 monthlyinstallment(s)
BEACON INSURANCE GROUP1919 Broadway Street
Mount Vernon, IL 62864
618-242-5411
Berkshire Hathaway GUARD Insurance Companies - P.O. Box A-H - Wilkes-Barre, PA 18703 - www.guard.com - phone: 1-800-673-2465
Total Estimated Premium:
Established:1983
Ultimate Parent:Berkshire Hathaway Inc.
Insurance Companies:AmGUARD, EastGUARD, NorGUARD, and WestGUARD
A.M. Best Company Rating:A+ (”Superior”); Financial Size Category X
CEO/President:Sy Foguel, ACAS, FILAA
Locations:Home office in PA; eight satellite offices across the United States
Specialty:Property & Casualty insurance
Products:*
For individuals, we feature Property coverage for:
� Homeowners
� Renters
� Condo Unit Owners
A Personal Umbrella is also available.
For businesses, we feature a commercial product suite that can generallyinclude one or more of the basic policies typically sought: Workers’Compensation, Property/Liability (via a Businessowner’s Policy),Commercial Auto, Commercial Umbrella, and/or Professional Liability.
Operating Area:Nationwide for commercial lines. We have also begun offering personalProperty and Liability coverage in select states. (Visit www.guard.comfor details.)
Performance:Combined loss and expense ratio (consistently under 100%) thatoutperforms our peer group
Distribution Network:Independent Insurance Agents
Number of Policies Issued (2017):256,000
Gross Written Premium (2017):$1.3 billion
Services:Full range of underwriting, loss control, billing, and claims value-addedservices provided that help policyholders realize the full benefit of theircoverage . . . in the easiest possible way
*Not all products are available in all states or through all subsidiaries.
GUARDBerkshire Hathaway
Companies
Insurance
Berkshire Hathaway GUARD Insurance Companies
BERKSHIRE
ATHAWAYH INC.
About . . .
Berkshire Hathaway GUARD Insurance Companies P.O. Box A-H, Wilkes-Barre, PA 18703 www.guard.com phone: 1-800-673-2465� � �
Quick Facts
AA Rating
Standard & Poor’s(as of 2017)
Fortune 500 #2(as of 2017)
S&P 500
Global 500 #8(as of 2017)
ChairmanWarren Buffett
More AboutBerkshire Hathaway – an
international holding companywith diverse interests that
include insurance andreinsurance – is regularlyrecognized as one of the
largest and strongestorganizations in the world.
I hereby authorize _____________________________________ to initiate pre-authorized debit transfers on
behalf of my business for (select one) , using to the information outlined below:� �one-time use ongoing
Policy(ies): ______________________________________________________________________________If this authorization applies to multiple policies, list all. For each, include the policy # and/or type (i.e., Comp, etc.); also, indicate new or renewal.
Name of Policyholder: _____________________________________________________________________
Bank Account #: ________________________________ Bank Routing #: __________________________
Bank Name: _____________________________________________________________________________Name City State
Preferred Start Date: ______________________ Amount (if one-time Direct Draft): ___________________
Statement Delivery Preference: Fax E-mail Mail Fax # or E-mail: _________________________� � �
(OPTIONAL) Attach a voided check to assist us in verifying your account information.
Authorized Signature: __________________________________________ Date Signed: ________________
Printed Name: ______________________________________
Phone Number: ______________________________________We send Billing Statements to give you advance notice of each draft amount as a courtesy to you.(The procedure for calculating premium is set forth in your policy.) We cannot guarantee that youwill receive this notice or that the notice will be received in advance of the Direct Draft. Regardless,payment is still due in accordance with your policy terms.
Attn:
DD
PF-T
B/8
-14
Ed10
Payment Terms:Your down payment is due in our office within ten (10) days of the effective date of your policy. Alwaysinclude your Proposal Number on all correspondence and checks. (Note: For policyholders that use escrow
accounts, we can arrange to have bills sent to the mortgagee.)
Payment Options:� CREDIT CARD: www.guard.comGo to the at to register and make yourPolicyholder Service Center
payment OR call Customer Service at . A fee may apply.1-800-673-2465
� DIRECT DRAFT: Complete the Authorization form (below) and fax to Accounting Services 570-820-7968OR make your Direct Draft payment from the at . NoPolicyholder Service Center www.guard.comInstallment fee applies with ongoing Direct Draft payments.
� E-CHECK: 570-820-7968Fax a copy of your completed check to . MARK THE CHECK FOR “DRAFT,”
making sure not to obscure the routing number, account number, or payment amount.
� TELEPHONE PAYMENT: 1-800-673-2465Call Customer Service at .
� MAIL PAYMENT: Make check payable toand include the remittance voucher (below).
See Direct Draft and Mailing Remittance Forms below.
MAILING REMITTANCE SLIP
Customer Name:
Agency Name:
Proposal Number:
Total Premium:
Down Payment Amount:
Mail Payment To:
Direct Draft Authorization:
GUARDBERKSHIRE HATHAWAY
INSURANCECOMPANIES
Nancy Burklow
Nancy Burklow
Nancy Burklow
NAHO080789
NAHO080789
CREDIT CARD: Go to the Policyholder Service Center at www.guard.com to register and make your paymentOR call Customer Service at 1-800-673-2465. A fee may apply.
DIRECT DRAFT: Complete the Authorization form (below) and fax to Accounting Services at 570-820-7968OR make your Direct Draft payment from the Policyholder Service Center at www.guard.com. No Installmentfee applies with ongoing Direct Draft payments.e-CHECK: Fax a copy of your completed check to 570-820-7968. MARK THE CHECK "FOR DRAFT," makingsure not to obscure the routing number, account number, or payment amount.
TELEPHONE PAYMENT: Call Customer Service at 1-800-673-2465.MAIL PAYMENT: Make check payable to Berkshire Hathaway GUARD Insurance Companies and includeremittance voucher (below).
BEACON INSURANCE GROUP
$560.00
$112.00
Berkshire Hathaway GUARD Insurance CompaniesATTN: Accounts ReceivableP.O. Box A-H - 39 Public SquareWilkes-Barre, PA 18703-0020
Berkshire Hathaway GUARD (WestGUARD Insurance Company)
(Note: For policyholders that use escrow accounts, we can arrange to have bills sent to the mortgagee.)
To: Proposal NAHO080789
570-825-9900
www.guard.com
Wilkes-Barre, PA 18703-0020P.O. Box A-H • 39 Public Square
Berkshire Hathaway GUARD
Proposal of Insurance Nancy Burklow
for 06/04/2019 to 06/04/2020 Prospect Number NAHO080789
This quote will expire on 06/05/2019.
Fax#: 866-468-5803 Fax Number: 570-820-7968Phone Number: 618-242-5411 Phone Number:
Extension: / e-mail: Ali Klein - Mount Vernon, IL
BEACON INSURANCE GROUP
The portion of the Total Estimated Cost attributable to terrorism premium is $ 0.00.
Total Estimated Cost: $560.00
Direct BillPayment Method:
Type of Coverage: Homeowners
AmGUARD Insurance CompanyCarrier:
(Direct billed policies will be charged a fee of $7.00 per installment.)
Information Needed to Issue:
Copies of any dec page(s) or policy number(s) to keep the Special Insurance Discount.*
A signed copy of the Mine Subsidence Rejection Form is required if Mine Subsidence Coverage is not desired.*
Important Notes:
* A Direct Draft electronic fund transfer option is offered which requires no installment fees and no checks to be mailed. A sign-up sheet is enclosed and can alternatively be downloaded from our web site at www.guard.com or obtained by contacting Customer Service at 800-673-2465.
* WE MAY, BUT ARE NOT OBLIGATED, TO INSPECT YOUR PROPERTY. THIS INSPECTION MAY BE MADE BY US or MAY BE MADE ON OUR BEHALF. AN INSPECTION or ITS RESULTING ADVICE, REQUIREMENTS or REPORT DOES NOT WARRANT THAT YOUR PROPERTY IS SAFE, HEALTHFUL, or IN COMPLIANCE WITH THE LAWS, RULES or REGULATIONS. INSPECTIONS or REPORTS, WHICH MAY INCLUDE PHOTOGRAPHS OF THE PROPERTY, ARE FOR INSURANCE PURPOSES ONLY.
* THIS COVERAGE DOES NOT PROVIDE ANY FLOOD COVERAGE- FOR FLOOD COVERAGE PLEASE SPEAK WITH YOUR AGENT.
Prepared: 05/29/2019 @Z
PROP-2/2008You may call Customer Service at 1-800-673-2465
- 24 hours a day, 7 days a week.
Page 1 of 6
Proposal of Insurance for Nancy Burklow (cont.)
3548 Sherman St, Springfield, IL 62703-4855
The next sections of this proposal list the various insurance coverages and limits included in this Homeowner's policy for the Total Estimated Cost shown above; some are automatically included while
others reflect specific requests.
SECTION I: Property
Coverages:
A. Coverage A - Dwelling
B. Coverage B - Other Structures
C. Coverage C - Personal Property
D. Coverage D - Loss of Use
Deductibles:
All Perils
Theft Deductible
Windstorm/Hail
186,527
0
93,264
55,958
1000
Same as All Peril
1%
SECTION II: Liability
300,000
3,000
E. Coverage E - Personal Liability Limit
F. Coverage F - Medical Payments Limit
Prepared: 05/29/2019 @Z
PROP-2/2008You may call Customer Service at 1-800-673-2465
- 24 hours a day, 7 days a week.
Page 2 of 6
Proposal of Insurance for Nancy Burklow (cont.)
SECTION III: Additional Coverages
Additional Coverage Selected: Limits:
Business Property
Off-Premises Limit 1,500
On-premises Limit 2,500
Coverage C - Other Residences
Limit 9,326
Coverage C - Self-storage Facilities
Limit 9,326
Coverage C - Special Limits of Liability
Jewelry, Watches and Furs Limit 1,500
Money Limit 200
Securities Limit 1,500
Silverware, Goldware & Pewterware Limit 2,500
Firearms Limit 2,500
Portable Electronic Equipment in or upon a motor Vehicle Limit 1,500
Credit Card, Electronic Fund Transfer Card or Access Device, Forgery and Counterfeit Money Coverage
Limit 1,000
Damage to Property of Others
Limit 1,000
Debris Removal
Limit 5%/1,000
Fire Department Service Charge
Limit 500
Grave Markers
Limit 5,000
Home Systems Protection Coverage
Limit 50,000
Landlord's Furnishings
Limit 2,500
Limited Fungi, Wet or Dry Rot or Bacteria Coverage
Section I Limit 10,000
Section II Limit 50,000
Mine Subsidence
Limit 750,000
Service Line Coverage
Limit 10,000
Supplemental Loss Assessment Coverage
Residence Premises Limit 1,000
Prepared: 05/29/2019 @Z
PROP-2/2008You may call Customer Service at 1-800-673-2465
- 24 hours a day, 7 days a week.
Page 3 of 6
Proposal of Insurance for Nancy Burklow (cont.)
Trees, Shrubs and Other Plants
Limit 5%/500
Water Backup & Sump Overflow
Limit 5,000
Section IV: Rating Characteristics
Form Code:
Construction:
Dwelling Type:
Occupancy Type:
Year Built:
Number of Families:
HO 03 - Special Form
Frame
PRIMARY
Owner Occupied
1955
1
Territory:
Protection Class:
Primary Roof Cover:
Roof Upgrade Year:
037
01
Composition - Architectural Shingle
2014
Prepared: 05/29/2019 @Z
PROP-2/2008You may call Customer Service at 1-800-673-2465
- 24 hours a day, 7 days a week.
Page 4 of 6
Proposal of Insurance for Nancy Burklow (cont.)
SECTION V: Policy Forms
Form Number Form Name
WELCOME LETTERHO WEL LET
GUARDIAN FLYERHO GUARDIAN
HOME OWNERS POLICY DECLARATIONSHO DEC 07 18
LIMITED HOME DAY CARE COVERAGE ADVISORY NOTICE TO POLICYHOLDERSHO P 004 05 11
Notice of Consumer Rights Under the Fair Credit Report ActHO FCRA
ADVISORY NOTICE TO POLICYHOLDERSHO P 063 10 15
Illinois Earthquake Insurance Availability NoticeHO PN IL 01 04 18
PRIVACY POLICYHO PRIV POL
FRAUD STATEMENTIL N 001 09 03
Illinois Notice to Policyholders Regarding the Religious Freedom Protection and Civil Union ActIL N 175 11 11
U.S. TREASURY DEPARTMENT'S OFFICE OF FOREIGN ASSETS CONTROL ('OFAC') ADVISORY NOTICE TO POLICYHOLDERS
IL P 001 01 04
HOMEOWNERS 3 - SPECIAL FORMHO 00 03 05 11
WINDSTORM OR HAIL PERCENTAGE DEDUCTIBLEHO 03 12 05 11
LIMITED FUNGI, WET OR DRY ROT, OR BACTERIA COVERAGEHO 04 27 05 11
CREDIT CARD, FUND TRANSFER CARD, FORGERY AND COUNTERFEIT MONEY COVERAGEHO 04 53 10 00
LIMITED WATER BACK-UP and SUMP DISCHARGE or OVERFLOW COVERAGEHO 04 95 01 14
FUNCTIONAL REPLACEMENT COST LOSS SETTLEMENTHO 05 30 05 11
RESIDENCE PREMISES DEFINITION ENDORSEMENTHO 06 48 10 15
HOME-SHARING HOST ACTIVITIES AMENDATORY ENDORSEMENTHO 06 53 02 17
Special Provisions - IllinoisHO 112 01 04 18
MINE SUBSIDENCE RESIDENCE AND OTHER STRUCTURES - ILLINOISHO 23 88 06 12
MATCHING OF UNDAMAGED EXTERIOR SURFACING EXCLUSION DELETIONHO 99 78 03 18
LIMITED LOSS SETTLEMENT FOR WINDSTORM OR HAIL LOSSES TO ROOF SURFACINGHO 99 81 01 18
PROTECTIVE DEVICESHO 99 83 08 17
SERVICE LINE COVERAGEHO 99 89 06 17
HOME SYSTEMS PROTECTIONHO 99 90 06 17
Authorization and AttestationIL 99 00 08 13
Notice of Contact for ComplaintsPN IL 01 01 14
AIRCRAFT LIABILITY DEFINITION REVISED TO REMOVE EXCEPTION FOR MODEL OR HOBBY AIRCRAFTHO 34 02 02 17
Prepared: 05/29/2019 @Z
PROP-2/2008You may call Customer Service at 1-800-673-2465
- 24 hours a day, 7 days a week.
Page 5 of 6
Proposal of Insurance for Nancy Burklow (cont.)
PROPOSAL-05-29-2019-03 Accepted by:
Prospect's Signature:
Date:
DISCLAIMER This proposal/quote is not a binder. The Total Estimated Cost is based upon information provided to date and is subject to change even after coverage has been bound, based upon availability of additional pricing or underwriting information or considerations and/or upon the results of loss control surveys and compliance with recommendations. This summary of policy coverages, premium, and limits is not an insurance policy. For further details about the coverage, please review the policy forms and declarations pages. In the event of a conflict, the terms stated in the insurance policy shall govern. Please be aware that this proposal encompasses only the coverages listed and that those coverages are subject to the final terms and conditions stated in the policy. Our only offer of insurance is stated by the terms of this proposal, which can only be changed by our issuance of a new proposal.
Prospect Number: NAHO080789
Fax this signed proposal page to us at 570-820-7968
(print name)
Prepared: 05/29/2019 @Z
PROP-2/2008You may call Customer Service at 1-800-673-2465
- 24 hours a day, 7 days a week.
Page 6 of 6
ED1 (01/18)
Mine Subsidence Insurance Rejection Form
The Illinois Mine Subsidence Act (Article XXXVIIIA) requires that Mine Subsidence Insurance be available for any building in Illinois on policies providing fire and extended coverage beginning January 1, 1994. Coverage applies to direct physical loss of or damage to building. Additional details about the coverage can be provided by your agent.
If your insurance application is accepted by us and a policy is issued to you, Mine Subsidence coverage will be included. To reject this coverage, complete and return this waiver within 30 days of policy inception.
Reject Residence Premises ☐
I (We) do not desire Mine Subsidence coverage and hereby waive any right to such coverage under this policy or any future policy covering my (our) interest in the property identified above, unless I (we) request mine subsidence insurance coverage, in writing, at some future date.
_______________________________________________________ _______________________________ Policyholder/Applicant’s Name (Print) Policy Number
________________________________________________________ _______________________________ Policyholder/Applicant’s Signature Date
NAHO080789
3548 Sherman St, Springfield, IL 62703-4855
Auto Quote
Customer Information
Nancy Burklow3548 Sherman St Springfield, IL 62703-4855
Date Prepared: 05/28/2019
Proposed Policy Period: 06/04/2019 to 06/04/2020
Agent Information
BEACON INSURANCE GROUP INC 1919 BROADWAY ST MOUNT VERNON, IL 62864-2980
Phone Number: (618) 242-5411Email: [email protected]: www.beaconinsgroup.netAgent #: 250821
Call or email BEACON INSURANCE GROUP INC to start your protection with a monthly EFT down payment of $88.25.
PREMIUM SUMMARY PremiumVehicle Coverages $1,004.40Other Coverages $80.50Discounts & Safeco Safety Rewards Included
Your total policy premium for 12 months is $1,084.90
Your total policy premium for 12 months with the Paid in Full Discount is $985.10
Your total policy premium for 12 months with Automatic Bank Deduction is $1,035.10
DISCOUNTS & SAFECO SAFETY REWARDSAdvance QuotingViolation Free
Anti-Theft Coverage Homeowners Accident Free
DRIVER SUMMARYNancy Burklow - Rated
VEHICLE COVERAGES Limits / Deductibles
2017 Chry Pacifica
Bodily Injury Liability $100,000/$300,000 $215.00
Property Damage Liability $100,000 $176.40
Comprehensive $500 w/Full Glass $269.80
Collision $500 $343.20
Total Vehicle Premium $1,004.40
OTHER COVERAGES Limits / Deductibles PremiumMedical Payments $5,000 $33.80
Uninsured/Underinsured Motorist Bodily Injury $100,000/$300,000 $46.70
Accident Forgiveness Not Available --
This quote is provided without cost or obligation. It is not a contract or binder of coverage.
Safeco Insurance Company of Illinois
Auto Quote
Payment Options:
Automatic Deduction (EFT)
1. Full Payment $985.10 (Total Premium, no Installment Fee)
2. 2-Pay $494.55 (50% down payment + $2.00 Installment Fee)
3. 4-Pay $260.78 (3 months down payment + $2.00 Installment Fee)
4. Monthly Pay $88.25 (1 month down payment + $2.00 Installment Fee)
Recurring CC (RCC)
1. Full Payment $985.10 (Total Premium, no Installment Fee)
2. 2-Pay $497.55 (50% down payment + $5.00 Installment Fee)
3. 4-Pay $276.23 (3 months down payment + $5.00 Installment Fee)
4. Monthly Pay $95.40 (1 month down payment + $5.00 Installment Fee)
Bill By Mail
1. Full Payment $985.10 (Total Premium, no Installment Fee)
2. 2-Pay $497.55 (50% down payment + $5.00 Installment Fee)
3. 4-Pay $276.23 (3 months down payment + $5.00 Installment Fee)
4. Monthly Pay $185.82 (2 months down payment + $5.00 Installment Fee)
Safeco Insurance Company of Illinois