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<br />.RL[ <br /> <br />RLllnsurance Company <br />9025 N. LIndbergh Drive · Peoria, IL 61615. (309) 692-1000 <br />A stock Insurance company, hereIn called the Company. <br /> <br />POLICY DECLARATIONS <br /> <br />Policy Number: HUL0200045 <br />Renewal of: HUL0200045 <br /> <br />Broker Reference Number: <br /> <br />"NAMED INSURED" AND ADDRESS: <br />City Of Sunny Isles Beach <br />18070 Collins Avenue <br />Sunny Isles Beach, FL 33160 <br /> <br />AGENT/BROKER: <br /> <br />59649 Britt Paulk Ins Agency, Inc. <br />100 Glen Eagles Court <br />Carrollton. GA 30117 <br /> <br />POLICY PERIOD From 03116/2011 To 10/01/2011 at 12:01 AM Standard Time at your mailing address shown <br />above. <br /> <br />In consideration of the premium as outlined below and subject to all the terms of this Policy. this Company agrees to <br />provIde the insurance coverage as stated In the attached Policy. This premium may be subject to adjustment. <br />Coverage Part Premium <br />Hull $1,645.00 <br />TRIA $200.00 <br />See attached Tax, Fee & surcharge Schedule (OMP 900) if applicable. Taxes/Fees/Surcharges: $21.39 <br />Premium payable at Inception unless Payment Schedule (OMP 113) applies. Total Premium: $1,866.39 <br /> Minimum Premium: N/A <br />ADDITIONAL FORMS AND ENDORSEMENTS - MADE PART OF THIS POLICY AT TIME OF ISSUE <br />See Attached Schedule of Endorsements (OMP 2150) <br /> <br />'~~rJ(6 <br /> <br />Authorized Signature <br /> <br />OM? 100 (07/09) <br /> <br />INSURED <br />