Details
- Date
- Jan 21, 2026
- Amount
- $5,852.00
- Vendor
- Wright National Flood Insurance Company
- Processed
- 2026-02-04T04:21:21-05:00
- Original File
- Report_02042026_041935_000024.pdf
Summary
Flood insurance policy declaration page renewal from Wright National Flood Insurance Company for insured Johan Jongsma, covering property at 851 Brightwaters Blvd NE, St. Petersburg, FL. Policy period from 1/21/26 to 1/21/27 with building coverage of $250,000 and total annual payment of $5,852.00.
Notes
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OCR Text
---
## Page 1
WRIGHT
Wright National Flood Insurance Company Flood
A Stock Company
P.O. Box 33003
St. Petersburg, FL 33733-8003
Customer Service: 1-800-820-3242
Claims: 1-800-725-9472
FFL99.001 1025
9475261
1/21/26
2000 11523 FLD RGLR
### FLOOD DECLARATIONS PAGE
**RENEWAL**
National Flood Insurance Policy
| Policy Number | NFIP Policy Number | Product Type: |
|--------------|-------------------|---------------|
| 09 1152254689 03 | 1152254689 | Dwelling Form |
| Policy Period | Date of Issue | Agent Code | Prior Policy Number |
|--------------|-------------|------------|---------------------|
| From: 1/21/26 To: 1/21/27 12:01 am Standard Time | 01/21/2026 | 0731519 | 09 1152254689 02 |
**Agent** (727)797-0441
HUB INTERNATIONAL FLORIDA
4830 W KENNEDY BLVD STE 850
TAMPA FL 33609-2593
CCFN-CL@HUBINTERNATIONAL.COM
**Insured**
JOHAN JONGSMA
851 BRIGHTWATERS BLVD NE
ST PETERSBURG FL 33704-3719
**Property Location** (if other than above)
851 BRIGHTWATERS BLVD NE, ST PETERSBURG FL 33704
Address may have been changed in accordance with USPS standards.
### Rating Information
- **Rate Category:** Rating Engine
- **Primary Residence:** Y
- **Building Occupancy:** Single Family
- **Building Description:** Main Dwelling
- **Flood Risk:** AE
- **First Floor Height:** 2.1 ft
- **Method Used to Determine First Floor Height:** Elevation Certificate
- **Date of Construction:** 07/01/2007
- **Prior NFIP Claims:** 0
**Property Description:** Slab on Grade, 2 floors, Masonry Construction
### Coverage
| | | Deductible | Annual Premium |
|---|---|-----------|----------------|
| **BUILDING** | $250,000 | $10,000 | $6,392.00 |
| **CONTENTS** | NO CONTENTS COVERAGE | INSURED DECLINED CONTENTS COVERAGE | $0.00 |
> Your property's NFIP flood claims history can affect your premium. For more information contact your insurance agent or company.
**Coverage limitations may apply. See your Policy form for details.**
| | |
|---|---|
| ICC Premium: | $75.00 |
| Community Rating Discount: | $1,569.00 |
| FULL RISK PREMIUM: | $4,898.00 |
| DISCOUNTED PREMIUM: | $4,898.00 |
| Reserve Fund Assessment: | $882.00 |
| Federal Policy Service Fee: | $47.00 |
| HFIAA Surcharge: | $25.00 |
| **TOTAL ANNUAL PAYMENT** | **$5,852.00** |
**THIS IS NOT A BILL**
Premium Paid by: Insured
### Forms and Endorsements:
WFL 99.414 1021 1021 FFL 99.310 0224 0224 WFL 99.116 1021 1021
This policy is issued by NAIC company 11523
Wright National Flood Insurance Company A stock company
Copy Sent To: As indicated on back or additional pages, if any.
*Patricia Templeton-Jones, President*
07315190911522546892602102 00009 02812
Insured
---
## Page 2
FFL99.001 1025
9475261
1/21/26
09 1152254689 03
| **Agent** (727)797-0441 | **First Mortgagee** |
|:---|:---|
| HUB INTERNATIONAL FLORIDA | Loan 4036121330 |
| 4830 W KENNEDY BLVD STE 850 | VALLEY BANK |
| TAMPA FL 33609-2593 | PO BOX 2074 |
| | CARMEL IN 46082-2074 |
> **Dear Mortgagee:** The Reform Act of 1994 require you to notify the WYO company for this policy within 60 days of any changes in the servicer of this loan.
The above message applies only when there is a mortgagee on the insured location.
### Special Provisions:
This policy covers only one building. If you have more than one building on your property, please make sure they are all covered. See III. Property Covered within your Flood policy for the NFIP definition of "building" or contact your agent, broker, or insurance company. Please refer to the policy for complete terms, conditions, and exclusions. A full, digital copy of your flood policy form is available at www.wrightflood.com/policyforms.html. The form which applies to your policy coverage is:
Dwelling Form
For questions about your flood insurance policy rating, contact your agent or insurance company. To learn more about your flood risk please visit FloodSmart.gov/floodcosts.
### Claims Information:
Please contact your agent or go to www.wrightflood.com to enter your claim as well as receive important information to mitigate the damage to your property. If you need to reach the insurance company the number is 1-800-725-9472.
To prevent delays in claim handling, it is important to make sure that your policy information is up to date and accurate. Contact your insurance agent or company to make changes to your policy or visit floodsmart.gov/flood to learn more about flood insurance.
07315190911522546892602102 00009
Insured
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