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obsidian-yanxin/documents/dmv/jiang_2020/renter_insurance.md
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insurance renter's insurance Yanxin Lu, Xuewei Jiang 2020-11-21 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)