---
type: financial
category: dmv
person: Yanxin Lu, Xuewei Jiang
date: 2020-11-21
source: renter_insurance.pdf
---

# Renter's Insurance - Evidence of Insurance (Assurant)

## Policy Information

| Field | Value |
|---|---|
| **Application Number** | REN0661408 |
| **Effective Dates** | 11/21/2020 to 11/21/2021 12:01 AM |
| **Yearly Premium** | $226.00 |
| **Service Phone** | 1-877-900-0344 |

## Agent & Company

| Agent Address | Company Address |
|---|---|
| GEICO Insurance Agency, Inc. | American Bankers Insurance Company of Florida |
| One Geico Blvd | 11222 Quail Roost Drive |
| Fredericksburg, VA 22412 | Miami, FL 33157-6596 |

## Insured & Risk Address

| Insured Name & Mailing Address | Risk Address |
|---|---|
| YANXIN LU | 11950 IDAHO AVE |
| XUEWEI JIANG | APT 113 |
| 11950 IDAHO AVE APT 113 | LOS ANGELES, CA 90025 |
| LOS ANGELES CA 90025 | |

## Section I Coverage Information

| Coverage | Amount ($) |
|---|---|
| CONTENTS | $10,000 |
| LOSS OF USE | $2,000 |

## Section I Deductible Information

| Deductible | Amount ($) |
|---|---|
| STANDARD DEDUCTIBLE | $500 |

## Section II Coverage Information

| Coverage | Amount ($) |
|---|---|
| PERSONAL LIABILITY | $100,000 |
| MEDICAL PAYMENTS TO OTHERS | $1,000 |

## Endorsements

- REPLACEMENT COST CONTENTS
- WATER SEWER BACKUP

**NOTE: ALL COVERAGES ARE SUBJECT TO THE TERMS AND CONDITIONS LISTED IN THE POLICY FORMS.**

Form: HISASEOI-1217 (Page 1)

---

## Payment Receipt (Page 2)

**Payment Receipt For Application # REN0661408**

| Field | Value |
|---|---|
| **Total Yearly Premium** | $226.00 |
| **Down Payment** | $226.00 |
| **Remaining Balance** | $0.00 |
| **Effective Dates** | 11/21/2020 12:01 AM to 11/21/2021 12:01 AM |

**For Service, Call 1-877-900-0344**

### Agent & Company (repeated)

| Agent Address | Company Address |
|---|---|
| GEICO Insurance Agency, Inc. | American Bankers Insurance Company of Florida |
| One Geico Blvd | 11222 Quail Roost Drive |
| Fredericksburg, VA 22412 | Miami, FL 33157-6596 |

### Insured & Risk Address (repeated)

| Insured Name & Mailing Address | Risk Address |
|---|---|
| YANXIN LU | 11950 IDAHO AVE |
| XUEWEI JIANG | APT 113 |
| 11950 IDAHO AVE APT 113 | LOS ANGELES CA 90025 |
| LOS ANGELES CA 90025 | |

### Additional Interest

| Additional Interest Name & Mailing Address |
|---|
| The Adler Apartments |
| 11950 IDAHO AVE |
| LOS ANGELES CA 90025 |

Form: HISASPR-1217 (Page 2)