NEW YORK PROPERTY INSURANCE UNDERWRITING ASSOCIATION

PREMIUM QUOTATION DWELLING (V02)

CITY \ BOROUGH CONSTRUCTION OCCUPANCY COVERAGE
PERIL DESCRIPTION PROTECTION CLASS DEDUCTIBLE SEASONAL
NO. OF FAMILIES INSURANCE AMOUNT INFLATION GUARD OTHER CREDITS
   DESCRIPTION    
     AMOUNT   
  PREMIUM  
TOTAL PREMIUM:


NOTE:ALL POLICIES ARE SUBJECT TO A $50 MINIMUM PREMIUM