Written Paper

Confirmation Mailing Address: P.O. Box 17478, Irvine, CA 92623-7478 Customer Service: 1-888-205-8118 M-F 6:30am PST to 5:30pm PST

Form: COI-001Revised 09/2005

Name and Address of Insured: Additional Insured(s):

Policy Summary:

Policy Number:

Effective Date:

Coverage Limit

Personal Property Coverage

Additional Living Expenses

Personal Liability Coverage

Medical Payments to Others

Deductible:

Expiration Date:

Notice Date:

Insurance Company:

Insurance Company:

Claims (Toll Free):

NAIC#:

Agent:

Lic#:

Important Information

Insuring Agreement: Your complete policy will be mailed to you via U.S. Mail within 15 days. The policy is your contract for insurance, not the Insurance Election Form or this Confirmation of Insurance. Please review all information closely for accuracy when received. The information given here is only a summary of coverage to be provided to you by this policy. We will provide insurance described in the policy in return for the premium and your

compliance with all provisions of the policy including endorsements.

Policy Cancellation: Your policy will NOT automatically terminate when you move-out. You must inform us of your cancellation in writing to avoid any further premium being billed to you or deducted from your account. You may also cancel your policy on-line at http://www.eRenterPlan.com. Notice of Cancellation: Your leasing office or apartment community manager may be notic ed of any notice of cancellation or non-renewal of your policy. Premium Installment Charges: If you have chosen to have your periodic premium installment payments debited from your bank account or credit card, please note that these periodic installments will be charged to your account roughly 7 to 14 days prior to your installment due date. This is for your protection and allows us sufficient time to notify you in writing in the event your account is closed or your credit card is declined by your issuing bank.

Any new resident must be added to the policy in order to be eligible for coverage. Resi- dents can be added or removed by logging onto http://www.eRenterPlan.com

Mailing Address: Policyholder Contact Information:

Telephone #:

Email Address:

Premium Installments:Optional Coverages: Your credit/debit card will be debited Monthly for your period premium installments. The debit will occur on or about the following dates : 05/11/2019, 06/11/2019, 07/11/2019, 08/11/2019, 09/11/2019, 10/11/2019, 11/11/2019, 12/11/2019, 01/11/2020, 02/11/2020, 03/11/2020, 04/11/2020

Printed: 3/11/2019

Pet Damage Liability Coverage,Water Backup of Sewers and Drains

$250

$1,000

$100,000

$30,000

330915261

LeasingDesk Insurance Services

28401

844-845-6690

American National Property and Casualty Company

04/26/2020 12:01 AM STD

04/26/2019 12:01 AM STD

32HQ0CZ90

[email protected]

9192571582

DURHAM NC 27703

2011 COPPER LEAF WAY Apt 112

JASON MUELLER

80766304 Interested Party: Artisan At Brightleaf

3/11/2019

2011 COPPER LEAF WAY

APT 112

DURHAM NC 27703