0002147 MAIL TO: AIC/IDEAL INSURANCE AGENCY 326 3RD STREET PO BOX 558 LAKEWOOD, NJ 08701 AGENT COPY RUTGERS CASUALTY INSURANCE COMPANY AMOUNT DUE HOMEOWNERS PREMIUM NOTICE 2250 CHAPEL AVENUE WEST, SUITE 200 CHERRY HILL NJ 08002 (800) 234-5439 496.71 DUE DATE 03/27/2014 POLICY NUMBER HOJ 0001364 20 02/10/2014 NOTICE DATE AGENT NAME AND ADDRESS MORDECHAI STARESHEFSKY & TZIPORAH STARESHEFSKY 39 WHISPERING PINES LANE LAKEWOOD NJ 08701 0002147 AIC/IDEAL INSURANCE AGENCY 326 3RD STREET PO BOX 558 LAKEWOOD, NJ 08701 PH: 732-363-8300 DATE CURRENT DESCRIPTION 02/10/2014 02/10/2014 AMOUNT DUE Renewal Service Charge PRIOR BALANCE PAY THIS AMOUNT 492.71 4.00 496.71 TOTAL CURRENT DUE 496.71 496.71 ANY TRANSACTION OCCURRING AFTER THE DATE OF THIS BILLING WILL BE REFLECTED IN YOUR NEXT NOTICE. KEEP THIS PORTION FOR YOUR RECORDS REMOVE THIS PORTION AND RETURN WITH YOUR RECEIPT YOUR CANCELLED CHECK IS YOUR RECEIPT PLEASE MAKE CHECKS PAYABLE TO: RUTGERS CASUALTY INSURANCE COMPANY MORDECHAI STARESHEFSKY & TZIPORAH STARESHEFSKY 39 WHISPERING PINES LANE LAKEWOOD NJ 08701 PLEASE: DO NOT STAPLE CHECK BE SURE TO SIGN YOUR CHECK MAIL IN THE ENCLOSED ENVELOPE WRITE YOUR POLICY NUMBER ON THE CHECK SEND NO CORRESPONDENCE WITH PAYMENT NOTICE DATE: 02/10/2014 DUE DATE: 03/27/2014 RUTGERS INSURANCE COMPANIES P.O. BOX 1923 HICKSVILLE NY 11802 POLICY NUMBER AMOUNT DUE HOJ 0001364 20 496.71 000529HOJ000136420MORDECHAI0STARESHEFSKY000000000000496710327140 RUTGERS CASUALTY INSURANCE COMPANY 2250 Chapel Avenue W., Suite 200 Cherry Hill, New Jersey 08002-2094 1-800-234-5439 HOMEOWNER POLICY PROGRAM POLICY NUMBER HOJ 0001364 20 12:01 A.M. STANDARD TIME POLICY PERIOD 03/27/2014 TO 03/27/2015 AT THE RESIDENCE PREMISES AND FOR SUCCESSIVE POLICY PERIODS AS STATED BELOW NO GRACE PERIOD. COVERAGE EXPIRES UNLESS PAYMENT RECEIVED BEFORE INSURED NAME AND 03/27/2014 . MORDECHAI STARESHEFSKY & TZIPORAH STARESHEFSKY 39 WHISPERING PINES LANE LAKEWOOD NJ 08701 ADDRESS 0002147 FOR 732-363-8300 PLEASE AIC/IDEAL INSURANCE AGENCY 326 3RD STREET PO BOX 558 CONTACT LAKEWOOD, NJ 08701 SERVICE RENEWAL The residence premises covered by this policy is located at the above address unless otherwise stated: We will provide the insurance described in this policy in return for the premium and compliance with all applicable policy provisions. If we elect to continue this insurance, we will renew this policy if you pay the required renewal premium for each successive policy period, subject to our premiums, rules and forms then in effect. You must pay us prior to the end of the current policy period or else this policy will expire. Insurance is provided only with respect to the following coverages for which a limit of liability is specified, subject to all conditions of this policy. SECTION I COVERAGES A. Dwelling B. Other Structures C. Personal Property D. Loss of Use LIMITS OF LIABILITY $239,825.00 $23,983.00 $167,878.00 $71,948.00 POLICY PREMIUMS ENDORSEMENT PREMIUM $718.00 $250.00 TOTAL POLICY PREMIUM $976.71 BASIC POLICY PREMIUM SECTION II COVERAGES E. Personal Liability Each Occurrence F. Medical Payments to Others Each Person $500,000.00 $1,000.00 Total Premium includes New Jersey Property Liability Insurance Guaranty Association surcharge of: $500 Section I Coverages are subject to the following deductibles: ALL PERILS $8.71 Endorsements made part of this policy at time of issue: $50.00 $28.00 $101.00 $50.00 $20.00 $1.00 Elite Protection Coverage Equipment Breakdown Coverage Personal Property Repl Cost Water Back Up & Sump Overflow Identity Recovery Coverage Workers Compensation Coverage Forms made part of this policy at time of issue. Current edition of forms will be submitted at each renewal date for earlier editions if revised during the previous policy term. HO0129 NJH09 HO2492 HO0496 NJH22 HO0576 HO0005 HO0420 (11/07) (3/01) (4/02) (10/00) (2/03) (5/11) (10/00) (10/00) Special Provisions - NJ Information Regarding Flood New Jersey Worker Compensation No Home Day Care Business Liab NJ EQ Ins Availability Notice Prop/Liab Liquid Fuel Coverage Comprehensive Form Specified Add'l Amt Ins Covg A AGENT COPY RUTGERS CASUALTY INSURANCE COMPANY 2250 Chapel Avenue W., Suite 200 Cherry Hill, New Jersey 08002-2094 1-800-234-5439 HOMEOWNER POLICY PROGRAM POLICY NUMBER HOJ 0001364 20 POLICY PERIOD 03/27/2014 TO 03/27/2015 12:01 A.M. STANDARD TIME AT THE RESIDENCE PREMISES AND FOR SUCCESSIVE POLICY PERIODS AS STATED BELOW INSURED NAME AND MORDECHAI STARESHEFSKY & TZIPORAH STARESHEFSKY 39 WHISPERING PINES LANE LAKEWOOD NJ 08701 ADDRESS FOR 0002147 732-363-8300 PLEASE AIC/IDEAL INSURANCE AGENCY 326 3RD STREET PO BOX 558 CONTACT LAKEWOOD, NJ 08701 SERVICE RENEWAL Endorsements made part of this policy at time of issue (continued): Forms made part of this policy at time of issue (continued): HO0416 HO0427 PCH2125 HO0495 NJH03 NJH05 RC0024 RC0025 (10/00) (4/02) (1/11) (10/00) (7/08) (7/08) (7/12) (7/12) Premises Alarm or Fire Prot Limited Fungi Coverage Elite Protecion Package Water Back Up & Sump Overflow Equipment Breakdown Coverage Equipment Breakdown Ren'l Ltr Important Notice Fuel Coverage Advisory Notice Fuel Coverage AGENT COPY RUTGERS CASUALTY INSURANCE COMPANY 2250 Chapel Avenue W., Suite 200 Cherry Hill, New Jersey 08002-2094 1-800-234-5439 HOMEOWNER POLICY PROGRAM POLICY NUMBER HOJ 0001364 20 POLICY PERIOD 03/27/2014 TO 03/27/2015 12:01 A.M. STANDARD TIME AT THE RESIDENCE PREMISES AND FOR SUCCESSIVE POLICY PERIODS AS STATED BELOW INSURED NAME AND MORDECHAI STARESHEFSKY & TZIPORAH STARESHEFSKY 39 WHISPERING PINES LANE LAKEWOOD NJ 08701 ADDRESS FOR 0002147 732-363-8300 PLEASE AIC/IDEAL INSURANCE AGENCY 326 3RD STREET PO BOX 558 CONTACT LAKEWOOD, NJ 08701 SERVICE RENEWAL Endorsements made part of this policy at time of issue (continued): Forms made part of this policy at time of issue (continued): NJH04 NJH06 HO0490 (7/08) (7/08) (10/00) Identity Recovery Coverage IRC Policyholder Notice Personal Property Repl Cost AGENT COPY RATING INFORMATION State: NJ No. of Families: 00002 Premium Group: Territory: 055 Construction Year: 2000 County: OCEAN Protection Class: 05 Rating Track: M Construction: Frame MORTGAGEE INFORMATION If a mortgagee is named in this policy, we will continue this insurance for the mortgagee's interest for ten days after written notice of termination to the mortgagee and then this policy will terminate. FIRST MORTGAGEE SECOND MORTGAGEE THIRD MORTGAGEE Direct Bill -- Premium to be paid by THE INSURED Date Prepared: 02/10/2014 AGENCY INPUT
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