Insurance Flood Endorsement

INSURANCE FLOOD ENDORSEMENT

Policy Identification

Insurer:

Policy Number:     Endorsement Effective Date:

Named Insured / Applicant

Date of Birth:     Contact Phone:

Policy Details — Flood Coverage

Coverage Limit (Building): $     Coverage Limit (Contents): $

Deductible (per occurrence): $     Annual Premium Adjustment: $

Policy Period From:     To:

Coverages Added or Modified by This Endorsement

The following coverages are expressly provided or modified under the terms of this Flood Endorsement. Coverage applies only if the corresponding box is checked.

Building (Dwelling) Coverage    Limit: $

Personal Property / Contents Coverage    Limit: $

Basement Coverage (subject to sublimit)    Sublimit: $

Additional Living Expense (ALE)    Limit: $

Debris Removal / Reasonable Cleanup Costs    Limit: $

Ordinance or Law Coverage (building ordinance upgrades)    Limit: $

Exclusions and Limitations

Coverage under this endorsement is subject to the following exclusions and limitations. The insured acknowledges that these items are not covered unless specifically endorsed in writing.

Loss due to pollution, contamination, chemical or biological agents

Loss due to wear, gradual deterioration, rust, corrosion or mold not resulting from a flood event

Ordinance or law upgrades except where Ordinance or Law Coverage is selected above

Pre-existing damage and latent defects

Sewer or drain backup except where explicitly stated in this endorsement

Conditions and Duties of the Insured

1. This endorsement supplements and forms part of the policy identified above. Except as expressly modified herein, all terms, conditions, exclusions and limits of the policy remain in full force.

2. Notice of Loss: The insured must notify the insurer as soon as practicable after discovery of loss. Proof of loss must be submitted within days of the insurer's request, unless a longer period is required by law.

3. Duties After Loss: The insured shall take reasonable steps to protect property from further damage, preserve damaged property for inspection, and cooperate with the insurer's investigation, including providing inventories and records as requested.

4. Subrogation: To the extent of any payment, the insurer shall be subrogated to the rights of the insured against any third party responsible for the loss. The insured must execute and deliver instruments and papers required to secure such rights.

5. Adjustments and Appraisal: In case of dispute as to the amount of loss, either party may demand an appraisal as set forth in the policy. This endorsement does not waive any policy condition requiring appraisal.

Mortgagee / Additional Interested Party

Interest of Mortgagee / Payee:     Recovery Sharing Percentage:

Supporting Documentation

The following documentation is required to support coverage and premium changes under this endorsement. Check all that are provided and attach to the policy file.

Elevation Certificate

Photographs of property condition

Floor plans / property diagrams

Prior flood claims history

Declaration and Certification

By signing below the insured certifies that the information contained in this endorsement request is true and correct to the best of their knowledge. The insured understands that material misrepresentation or omission of facts may void coverage for the subject loss and may constitute insurance fraud. Acceptance of this endorsement by the insurer is effective only when issued in writing and attached to the policy identified above.

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