4/25/2016

(800) 8914222 Ext.

THE AUTO CLUB GROUP

THE AUTO CLUB GROUP

ASI PREFERRED

2027.06

Agency Info:

Client Name:

Account #:

16-102-000587

FLP251922

Tracking #:

Policy #:

LARGO, FL 33770

1576 ROSERY RD NE

PAULA SANTIAGOInsured:

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form

ati

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Agency Memo / AlertEBucket =

Description =

Form Question # Form Value Client Value Reason

UnderScore Policy Summary

BucketForm_52190 56 TRUE TRUE Tree Limbs >= 3 inches in diameter overhanging E

YOU AGREE THAT YOUR REQUEST FOR THIS REPORT IS PERMITTED BY LAW AND THAT YOU INTEND TO USE THE REPORT ONLY FOR A PURPOSE PERMITTED BY THE FAIR CREDIT

REPORTING ACT AND LOCAL LAW AND NO OTHER PURPOSE. THIS REPORT IS BASED ON OBSERVATION AND INFORMATION PROVIDED TO US. FOR THE FEE CHARGED, WE DO NOT

ASSUME ANY LIABILITY ARISING OUT OF THE USE OR MISUSE OF THIS REOIRT BY YOU OR OTHERS. YOU AND ANY OTHER USER AGREE TO HOLD US FREE FROM ANY LIABILITY.

(C) Copyright 2007 - National Risk Services, Inc.

Po

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form

ati

on PAULA SANTIAGOInsured:

Agency:

Agency Phone:

Client:

Tracking Number:

Policy Number:

LARGO, FL 33770

1576 ROSERY RD NE

THE AUTO CLUB GROUP

(800) 8914222 Ext.

ASI PREFERRED

16-102-000587

FLP251922

38. There is an enclosed in-ground pool on the rear side.

56. Tree limbs greater than 3" overhang on the left side.

YOU AGREE THAT YOUR REQUEST FOR THIS REPORT IS PERMITTED BY LAW AND THAT YOU INTEND TO USE THE REPORT ONLY FOR A PURPOSE PERMITTED BY THE FAIR CREDIT

REPORTING ACT AND LOCAL LAW AND NO OTHER PURPOSE. THIS REPORT IS BASED ON OBSERVATION AND INFORMATION PROVIDED TO US. FOR THE FEE CHARGED, WE DO NOT

ASSUME ANY LIABILITY ARISING OUT OF THE USE OR MISUSE OF THIS REOIRT BY YOU OR OTHERS. YOU AND ANY OTHER USER AGREE TO HOLD US FREE FROM ANY LIABILITY.

Page 1 of 1

16-102-000587Dwelling Observation Survey (52190)2027.06

Insured: PAULA SANTIAGOLocation: 1576 ROSERY RD NE

City: LARGO State: FL Zip: 33770 Telephone: Coverage Amount: 190000.0000

Policy #: FLP251922Company: ASI PREFERRED

Agent: THE AUTO CLUB GROUPAgent Phone: (800) 8914222

Year Built: 1964 Sq Footage: 1303

Acct: Date: 0 4 / 2 1 / 2 0 1 6

DWELLING DESCRIPTION 01. Interview obtained. If so, whom?: Paula Santiago 02. Unable to confirm address 03. Type of dwelling: More than 4 family 4 family 3 family 2 family 1 family 04. Occupancy: Owner occupied Tenant occupied Vacant Seasonal Not interviewed 05. Commercial construction converted to residential Evidence of student housing Converted from single-family to multi-family 06. Non-traditional construction: A-frame construction Geodesic dome Earthen home Straw / Hay HUD tagged home Log home 06A. If log home: Log siding 1/2 log Full log 06B. If full log: Milled / Manufactured Handcrafted 07. Number of stories: (Check all that apply.) Other: 1 1.5 2 2.5 3 Bi-level Tri-level

1 9 6 4 08. Year built: Estimated Per interview 09. Foundation: (Check all that apply.) Basement Slab Crawl Space Pier & Post

Description of other: 10. Construction: Frame: % Masonry veneer: % Masonry: 1 0 0 % Other: % 10A. If frame, is any cement fiber exterior cladding present? Yes No Unknown

Other 11. Roof covering: (Check all that apply.) Composition Wood Tile Rubber Tar & gravel Other: 12. Roof type: (Check all that apply.) Gable Hip Gambrel Mansard Flat

13. Estimated roof life remaining: Less than 5 years 5 to 10 years More than 10 years 14. Current HVAC system: (Check all that apply.) Central Heat & Air Evaporative cooler Window units DWELLING CONCERNS

Paint chipping / peeling 15.Exterior wall / siding concerns 16.Foundation concerns 17.Open foundation 18.

19. Elevated surface concern: (Porches, decks, balconies, etc. Check all that apply.) Broken railing(s) In need of repair 19A. If missing railing(s), inches above ground: (Check all that apply.) 12" - 24" 25" - 35" 36" - 72" > 72" 20. Step problem(s): Steps in need of repair Broken handrail(s) Missing handrail(s): (Check all that apply.) 3 steps 4 steps 5 or more steps 21. Suspicion of synthetic stucco (EIFS) 22. Suspicion of asbestos siding 23. Gutter concerns 24. Renovations underway 25. Broken window(s) 26. Boarded window(s) 27. Roof in need of repair 28. Evidence of ice dams 29. Solid fuel device 30. Evaporative cooler on the roof 31. Wood shake siding

PREMISE CONCERNS 32. Evidence of dog(s) (not observed): (Check all that apply.) "Beware of Dog" sign noted Heard barking from inside house Dog house on premises 33. Dog(s) observed: Dog 1: Aggressive or vicious Bite history Predominant breed:

Dog 2: Aggressive or vicious Bite history Predominant breed:Dog 3: Aggressive or vicious Bite history Predominant breed:

34. Metal security bars on window(s) No quick releases evident 35. Outbuilding(s) on premises: (Check all that apply.) Need(s) paint Need(s) repair 400 - 599 sq ft 600 - 799 sq ft 800 sq ft or larger 36. Business on premises Type: Inventory maintained Employees Customer traffic 37. Heating oil tank(s) Underground 38. SlideSwimming pool(s): (Check all that apply.) Unfenced Non-latching gate In-ground Diving board 39. Un-nettedTrampoline(s): (Check all that apply.) Unfenced 40. Unfenced UncoveredHot tub or spa: (Check all that apply.) 41. Retaining wall In need of repair A. Check all that apply. Height: < 4' 4-6' > 6' Length: < 10' 10-20' > 20' B. Est. length (ft): 42. Height above water: (In feet.) Lake/pond within 1,000 feet Distance from water: (In feet.) 43. River/canal within 1 mile Distance from water: (In feet.) Height above water: (In feet.) 44. Ocean/tidewater within 1/2 mile Distance from water: (In feet.) Height above water: (In feet.) 45. Subject to flooding

YOU AGREE THAT YOUR REQUEST FOR THIS REPORT IS PERMITTED BY LAW AND THAT YOU INTEND TO USE THE REPORT ONLY FOR A PURPOSE PERMITTED BY THE FAIR CREDIT REPORTING ACT AND LOCAL LAW AND NO OTHER PURPOSE. THIS REPORT IS BASED ON OBSERVATION AND INFORMATION PROVIDED TO US. FOR THE FEE CHARGED, WE DO NOT ASSUME ANY LIABILITY ARISING OUT OF THE USE OR MISUSE OF THIS REPORT BY YOU OR OTHERS. YOU OR ANY OTHER USER AGREE TO HOLD US FREE FROM ANY LIABILITY.

46. Subject to landslide 47. Hillside / Slope: Degree of slope: 48. Distance:Brush or forest within 300 feet: 0 - 50 ft 51 - 100 ft 101 - 300 ft 49. Farming or ranching 50. Farm animal(s)/livestock 51. Exotic animal(s) 52. Above-ground gasoline

or diesel tank(s) 53. Above-ground LP tank(s)

54. Sidewalk(s) in need of repairSurface elevation change:

< 1" 1" - 3" > 3" 55. Driveway(s) in need of repair

Surface elevation change: < 1" 1" - 3" > 3"

56. Tree limb(s) overhanging roof Limbs diameter < 3" Limbs diameter 3" or more

57. Tree limb(s) touching roof Limbs diameter < 3" Limbs diameter 3" or more

58. Playground equipment

59. Junk car(s) 60. Appliance(s) 61.

Trip or fall hazard(s)Lumber

62. Housekeeping 63. Property for sale 64. Property for rent

65. Chimney concern(s) 66. 67. Lack of landscape maintenance 68. Tree house(s) 69. Exterior electrical concern(s)

PROTECTION 70. Dwelling on unpaved road: Mile(s) from pavement: < 1 1 - 5 > 5 71. Number of other permanent residences within view of dwelling: None 1 - 2 3 - 4 5 - 6 More than 6 72. Dwelling located on beachfront within 250 feet of ocean/gulf 73. Dwelling located on more than 5 acres 74. Dwelling located in secured subdivision. 74A. Secured by: Attended guard house Unattended guard house Keypad and gate only

Historical district

Asbestos shingle Metal (corrugated) Metal (tin)

75. If dwelling is located in secured subdivision, single entrance only.

L1/S

15'

29'

15'

16'

25'

28'

17' SP

10'

PC 14'

AG

8'

22'

23'

OP 6'

6'

SPE

31'

14'

37'

17'

Name PAULA SANTIAGO Reference Number 16-102-000587 Policy Number FLP251922

(C) 2006 - 2014 National Risk Services, Inc.

Area Name Sign Multiplier Perimeter (ft.) Area Value (sq. ft.) Living Area L1/S + 1 182 1303 Summary Living Area 1303 sq.ft. Porch Area SP + 1 48 140 OP + 1 24 36 SPE + 1 108 611 Summary Porch Area 787 sq.ft. Patio/Deck Area PC + 1 70 294 Summary Patio/Deck Area 294 sq.ft. Garage Area AG + 1 90 506 Summary Garage Area 506 sq.ft.

Agent Phone:

Agent:

Company:

Pol. #:

Zip:State:City:

Location:

Insured:

Photo Sheet

YOU AGREE THAT YOUR REQUEST FOR THIS REPORT IS PERMITTED BY LAW AND THAT YOU INTEND TO USE THE REPORT ONLY FOR A PURPOSE PERMITTED BY THE FAIR CREDIT REPORTING ACT AND LOCAL LAW AND NO OTHER PURPOSE. THIS REPORT IS BASED ON OBSERVATION AND INFORMATION PROVIDED TO US. FOR THE FEE CHARGED, WE DO NOT ASSUME ANY LIABILITY ARISING OUT OF THE USE OR MISUSE OF THIS REPORT BY YOU OR OTHERS. YOU OR ANY OTHER USER AGREE TO HOLD US FREE FROM ANY LIABILITY.

Photo Description:

Photo Description:

Address

Front

PAULA SANTIAGO

1576 ROSERY RD NE

LARGO FL 33770

FLP251922

ASI PREFERRED

THE AUTO CLUB GROUP

(800) 8914222 Ext.

Agent Phone:

Agent:

Company:

Pol. #:

Zip:State:City:

Location:

Insured:

Photo Sheet

YOU AGREE THAT YOUR REQUEST FOR THIS REPORT IS PERMITTED BY LAW AND THAT YOU INTEND TO USE THE REPORT ONLY FOR A PURPOSE PERMITTED BY THE FAIR CREDIT REPORTING ACT AND LOCAL LAW AND NO OTHER PURPOSE. THIS REPORT IS BASED ON OBSERVATION AND INFORMATION PROVIDED TO US. FOR THE FEE CHARGED, WE DO NOT ASSUME ANY LIABILITY ARISING OUT OF THE USE OR MISUSE OF THIS REPORT BY YOU OR OTHERS. YOU OR ANY OTHER USER AGREE TO HOLD US FREE FROM ANY LIABILITY.

Photo Description:

Photo Description:

Rear

Left

PAULA SANTIAGO

1576 ROSERY RD NE

LARGO FL 33770

FLP251922

ASI PREFERRED

THE AUTO CLUB GROUP

(800) 8914222 Ext.

Agent Phone:

Agent:

Company:

Pol. #:

Zip:State:City:

Location:

Insured:

Photo Sheet

YOU AGREE THAT YOUR REQUEST FOR THIS REPORT IS PERMITTED BY LAW AND THAT YOU INTEND TO USE THE REPORT ONLY FOR A PURPOSE PERMITTED BY THE FAIR CREDIT REPORTING ACT AND LOCAL LAW AND NO OTHER PURPOSE. THIS REPORT IS BASED ON OBSERVATION AND INFORMATION PROVIDED TO US. FOR THE FEE CHARGED, WE DO NOT ASSUME ANY LIABILITY ARISING OUT OF THE USE OR MISUSE OF THIS REPORT BY YOU OR OTHERS. YOU OR ANY OTHER USER AGREE TO HOLD US FREE FROM ANY LIABILITY.

Photo Description:

Photo Description:

Right

Tree limbs overhanging

PAULA SANTIAGO

1576 ROSERY RD NE

LARGO FL 33770

FLP251922

ASI PREFERRED

THE AUTO CLUB GROUP

(800) 8914222 Ext.

Agent Phone:

Agent:

Company:

Pol. #:

Zip:State:City:

Location:

Insured:

Photo Sheet

YOU AGREE THAT YOUR REQUEST FOR THIS REPORT IS PERMITTED BY LAW AND THAT YOU INTEND TO USE THE REPORT ONLY FOR A PURPOSE PERMITTED BY THE FAIR CREDIT REPORTING ACT AND LOCAL LAW AND NO OTHER PURPOSE. THIS REPORT IS BASED ON OBSERVATION AND INFORMATION PROVIDED TO US. FOR THE FEE CHARGED, WE DO NOT ASSUME ANY LIABILITY ARISING OUT OF THE USE OR MISUSE OF THIS REPORT BY YOU OR OTHERS. YOU OR ANY OTHER USER AGREE TO HOLD US FREE FROM ANY LIABILITY.

Photo Description:

Photo Description:

Tree limbs overhanging

Pool

PAULA SANTIAGO

1576 ROSERY RD NE

LARGO FL 33770

FLP251922

ASI PREFERRED

THE AUTO CLUB GROUP

(800) 8914222 Ext.