Laserfiche WebLink
Insured's Name SECURITY SOLUTIONS INTERNATIONAL INC. Policy # PAV0201745 <br />UMR# <br />(Lloyd's Policies Only) <br />Polic Dates From 06/11l2019 i To O6/11/202_0 <br />Surplus Lines Agents Name Gregg Kligler <br />Surplus Lines Agents Address 1835 Banks Road Mar ate FL 33063 <br />Surplus Lines Agents License # A142906 <br />Producing Agent's Name Combined Underwriters of Miami - Ronald Laster <br />Producing Agent's Physical Address 8240 NW 52nd Terrace, Ste 408, Miami, FL 33166 <br />"THIS INSURANCE IS ISSUED PURSUANT TO THE FLORIDA SURPLUS LINES LAW. <br />PERSONS INSURED BY SURPLUS LINES CARRIERS DO NOT HAVE THE PROTECTION OF THE <br />FLORIDA INSURANCE GUARANTY ACT TO THE EXTENT OF ANY RIGHT OF RECOVERY <br />FOR THE OBLIGATION OF AN INSOLVENT UNLICENSED INSURER" <br />"SURPLUS LINES INSURERS' POLICY RATES AND FORMS ARE NOT <br />APPROVED BY ANY FLORIDA REGULATORY AGENCY." <br />Policy Premium $150.00 <br />Inspection Fee $0.00 <br />Tax $7.50 <br />FHCF Assessment $0.00 <br />EMPA Surcharge $0.00 <br />Surplus Lines Agent's Countersignature <br />Policy Fee <br />Provider Fee <br />Service Fee <br />Citizen's Assessment <br />$0.00 <br />$0.00 <br />$0.15 <br />$0.00 <br />❑ "THIS POLICY CONTAINS A SEPARATE DEDUCTIBLE FOR HURRICANE OR <br />WIND LOSSES, WHICH MAY RESULT IN HIGH OUT-OF-POCKET EXPENSES <br />TO YOU." <br />"THIS POLICY CONTAINS A CO -PAY PROVISION THAT MAY RESULT IN <br />HIGH OUT-OF-POCKET EXPENSES TO YOU." <br />