A Call P O

GEICO Insurance Agency, LLC

Issued by HOMESITE INSURANCE COMPANY OF THE

MIDWEST

P.O. Box 5300

Binghamton, NY 13902-9953

Tel. 866-***-**** Fax 877-***-****

Insured Name and Mailing Address:

PHILLIP HATCHETT

7510 DOMINION PARK LN

APT 3102

CHARLOTTE, NC 28273-

Certificate of Insurance For Policy

Number 42409335

This policy covers the listed location(s) from:

12:01 AM January 11, 2025 through

12:01 AM January 11, 2026 (local time)

Send payment to:

PO Box 1409

NEWARK, NJ 07101-1409

HH D1 06 NC 03 22 Page 1 of 2

Insured Location

7510 DOMINION PARK LN APT 3102 CHARLOTTE, NC 28273- Deductible: $250

Coverage Limit

Section I - Property

C. Personal Property $20,000

D. Loss of Use $4,000

Section II - Liability

E. Personal Liability $100,000

F. Medical Payments to Others $1,000

Total Policy Premium $104.00

Total Amount Due $0.00

Total Amount Paid

*Please note that installment fees are not included in these totals and vary by payment plan option.

*$104.00

First Additional Interest

The Palmer

PO BOX 19219

ATLANTA, GA 31126

Notes:

H04 – Renters

HO 32 45 - Home-Sharing Host Activities Amendatory Endorsement HH D1 06 NC 03 22 Page 2 of 2

All information and representations herein are subject to the policy terms and conditions. Coverage is contingent upon receipt of the initial payment of premium prior to the effective date of the policy. Authorized Representative Date January 10, 2025

This evidence of property insurance is issued as a matter of information only and confers no rights upon the certificate holder. This evidence of property insurance does not amend, extend or alter the coverage afforded by the policy above.

Contact this candidate