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15.08.2019 15:24 17145444996 #0217 P 13/19 Policy Number101504-40-07 Additional Fee Information The following additional fees apply on an account, not per policy, basis. Effective Date:08-25.2019 • A service fee will be assessed on every installment invoice and will be included in the minimum amount due. However, If you choose to pay the entire account balance In full upon receipt of the first Installment, the fee will be waive 1. In addition, for accounts fullyenrolled In online billing and scheduled for recurring Electronic Funds Transfer (EFT) payments the fee will be waived. State Installment Fee All states except Alaska, Florida,Maryland, NewJersey And West Virginia $6.00 Alaska and Maryland Not applicable Florida $3.00 NewJersey $7.00 West Virginia $5.00 • Areturned payment fee applies per check, electronic transaction or other remittance which is not honored by your financial Institution for any reason Including but not limited to Insufficient funds or a closed account. NOTE: If the refumedpayment Is In response to a Notice of Cancellation, coverage still cancels on the cancellation effective date setforth In the notice. state NSF Fee All States Except Alaska, Florida, Indiana, Maine, Nebraska, New Jersey, North Dakota, Oklahoma, Virginia And West Virginia $30.00 North Dakota And Oklahoma $25.00 Nebraska And Indiana $20 00 Florida And West Virginia $15.00 Maine $10,00 Alaska, NewlerseyAnd Virginia Notapplicable • A late fee will be assessed on each Notice of Cancellatlon that is issued and will be included In the minimum amount due. state late Fee All States Except Alaska, Florida, Maryland, Missouri, Nebraska, New Jersey, Rhode Island, Vlrglnla, South Carolina And West Vlrglnla $20.00 Nebraska, Rhode Island And South Carolina $10,00 Alaska, Florlda, Maryland, Missouri, NewJersey, Virginia And West Vlrglnla Not applicable The following applies o n a per•pollcy basil a. ' A relnstatetnentfee of S25.00 will be assessed if the policy is reinstated over 30 days but under 6 months from the cancellation date. This fee does not applyto Florida, Indiana & Maryland orto Workers Compensation policies. One or more of the fees or charges described above may be deemed a part of premium under applicable state law. 56.2406 1.17 C2406203 page 3 of 3 ��IPA��°�