INSURED/BORROWER 

(Name and address as shown on Policy)

AGENT or BROKER

(Name and Business Address)

COMMERCIAL

PREMIUM FINANCE AGREEMENT LENDER:

LOAN DISCLOSURE

Total

Premiums,

Taxes and Fees

Cash Down

Payment

Documentary

Stamp Tax

(only applicable in

Florida)

Amount

Financed

(amount of

credit provided

on your behalf) 

Unpaid

Premium

Balance

FINANCE

CHARGE

(dollar amount

the credit will

cost you) 

Total of

Payments

(amount paid

after making all

scheduled

payments) 

ANNUAL

PERCENTAGE

RATE

(cost of credit as a

yearly rate) 

YOUR PAYMENT SCHEDULE WILL BE:

Number of Payments Amount of Each Payment First Installment Due

Installment Due Dates

SECURITY INTEREST. The named insured (herein referred to as "Insured") grants LENDER a security interest in the financed policies and any additional premiums

required under the financed policies, including (but only to the extent permitted by applicable law) all return premiums, dividend payments (not applicable in KY), and

loss payments which reduce unearned premium, subject to any mortgagee or loss payee interest. If any circumstances exist in which all premiums related to any

financed policy could become fully earned in the event of loss, LENDER shall be named a loss-payee with respect to such policy.

FINANCE CHARGE. The finance charge begins accruing on the earliest effective date of the policies listed in the Schedule of Policies. The finance charge may

include a nonrefundable service charge equal to the maximum amount permitted by law ($10 in AK, DE, NY & PA; $25 in NV; $12 in NJ; $15 in NC, RI & VA; $16

in MA; $20 in FL). The finance charge is computed using a 365-day calendar year. 

LATE PAYMENT. A late charge will be assessed on any installment at least 5 days in default (7 days in VA or such later date as required by applicable law. 10 days

in MA & TX). This late charge will equal 5% of the delinquent installment or the maximum late charge permitted by applicable law, whichever is less (greater of $10

or 5% in FL; greater of $25 or 1.5% in NJ; $5 maximum in DE, MT and ND; $100 maximum in MD; 5% in VA).

PREPAYMENT. The Insured is entitled to a refund of part or all of the unearned finance charge if the loan is prepaid in full prior to the last installment due date. The

refund shall be computed according to applicable law subject to any nonrefundable service charge. In VA the refund shall be calculated using the short rate method. In

CA the rebate is in compliance with Cal Fin Code § 18629. SCHEDULE OF POLICIES

Policy Number Full Name of Insurance Company and Name of General

Agent or Company Office to Which Premium is Paid Coverage Policy

Term

Effective Date Premiums, Taxes

and Fees

TOTAL

INSURED'S AGREEMENT:

1. In consideration of the premium payment being advanced by LENDER to the insurance companies listed in the Schedule of Policies, their representative or the Agent

or Broker listed above, the Insured promises to pay, to the order of LENDER, the Total of Payments subject to all of the provisions set forth in this Agreement. 

2. POWER OF ATTORNEY. INSURED IRREVOCABLY APPOINTS LENDER AS ITS "ATTORNEY-IN-FACT" with full power of substitution and full authority,

in the event of default under this Agreement, to (i) cancel the financed policies in accordance with the provisions contained herein, (ii) receive all sums assigned to

LENDER, and (iii) execute and deliver on behalf of the Insured all documents, forms and notices relating to the insurance policies listed on the Schedule of Policies in

furtherance of this Agreement (clauses (ii) and (iii) are not applicable in Florida). Insured agrees that this right to cancel will terminate only after all of Insured's

indebtedness under this Agreement is paid in full.

3. SIGNATURE & ACKNOWLEDGEMENT. Insured has signed and received a copy of this Agreement. If the Insured is not an individual, the undersigned is

authorized to sign this Agreement on behalf of the Insured. All named Insured(s), jointly and severally if more than one, agree to all provisions set forth in this

Agreement. Insured acknowledges and understands that entry into this financing arrangement is not required as a condition for obtaining insurance coverage.

NOTICE TO INSURED: (1) Do not sign this Agreement before you read both pages of it, or if it contains any blank space. (2) You are entitled to a completely

filled-in copy of this Agreement. (3) Under the law, you have the right to pay off in advance the full amount due and under certain conditions to receive a

partial refund of the finance charge. (4) 

Signature of Insured or Authorized Agent Date Signature of Agent    Date

The undersigned hereby warrants and agrees to the Agent or Broker

Representations and Warranties set forth herein. FIF0214Q

Mail Payments to: FIRST Insurance Funding Corp., PO Box 66468, Chicago, IL 60666-0468

Barrington Bank & Trust Company, N.A.

201 South Hough Street

Barrington, IL 60010

To Be Serviced By: FIRST Insurance Funding Corp. 450 Skokie Blvd, Suite 1000

Northbrook, IL 60062

P:(800)837-3707 F:(800)837-3709

www.firstinsurancefunding.com

Quote #: 000002725783 

Q#:000002725783 CONT_TYPE:BAR PRN:090214 CFG:07275RT:07275STD CRD:N/A BP:Bill F/D: 000 SUB:Agent 07275

Customer ID:n/a

Upstate Aerial Photography & Editing

204 Dairwood Dr

Simpsonville SC 29680

Phone: (619) 972-7382

COMMERCIAL LINES

Hill & Usher Insurance & Surety

3033 N. 44th Street, Suite 300

Phoenix AZ 85018

07275-0001

1,484.00 563.92 920.08 0.00 920.08 63.50 983.58 13.650

29th (Quarterly)

11/29/2014

3 327.86

TBD 12258-001 - Seneca Specialty Ins Co

001931 - Networked Insurance Agents

GL 12 08-29-2014

FIN TXS/FEES

ERN TXS/FEES

1,400.00

84.00

0.00

[ME%: 25.000 CX: 10]

1,484.00

Keep your copy of this Agreement to protect your legal rights.

2 Sept 2014
ADDITIONAL PROVISIONS OF PREMIUM FINANCE AGREEMENT

AGENT OR BROKER REPRESENTATIONS AND WARRANTIES

4. EFFECTIVE DATE. This Agreement will not become effective until it is accepted in writing by LENDER.

5. DEFAULT/CANCELLATION. Insured is in default under this Agreement if (a) a payment is not received by LENDER when it is due, (b) a proceeding in

bankruptcy, receivership, insolvency or similar proceeding is instituted by or against Insured, or (c) Insured fails to comply with any of the terms of this Agreement;

provided, however, when required by applicable law, Insured may be deemed in default only under clause (a) above. Clauses (b) and (c) are not applicable in FL,

MD, NV, NC or VA. At any time after default, LENDER can demand and has the right to receive immediate payment of the total unpaid amount due under this

Agreement even if LENDER has not received any refund of unearned premium. If the Insured is in default, LENDER has no further obligation under this Agreement

to pay premiums on the Insured's behalf, and LENDER may pursue any of the remedies provided in this Agreement or by applicable law. If a default by the Insured

results in cancellation of any insurance policy listed in the Schedule of Policies, the Insured agrees to pay a cancellation charge where allowed by applicable law (not

permitted in AK, FL, KS, KY, NV, NY, NC, PA, SC, TX or VA). If cancellation occurs, where permitted by law, the Insured agrees to pay LENDER interest on the

balance due at the contract rate or at the maximum lawful rate, whichever is less, until the balance is paid in full or until such other date as provided by applicable law.

6. RETURNED CHECK CHARGE. If an Insured's check is dishonored for any reason and if permitted by law, the Insured will pay LENDER a returned check

charge equal to the maximum fee permitted by law (not permitted in KY; $15 in FL & NV; $20 in VA; maximum of $25 in MD).

7. REINSTATEMENT. Once a Notice of Cancellation has been sent to any insurance company, LENDER has no duty to rescind it or to ask that the policy be

reinstated, even if LENDER later receives a payment from Insured. In the event LENDER requests reinstatement, such request does not guarantee that coverage will

be reinstated by the insurance company. Payments that LENDER receives after sending a Notice of Cancellation may be applied to Insured's account without

changing any of LENDER's rights under this Agreement.

8. LENDER'S RIGHTS AFTER THE POLICIES ARE CANCELLED. After any financed policy is cancelled, whether by LENDER, the Insured, or the insurance

companies listed in the Schedule of Policies, LENDER has the right to receive all unearned premiums and other funds assigned to LENDER as security herein and to

apply them to Insured's unpaid balance under this Agreement or any other agreement between the Insured and LENDER (in VA, only to policies financed under this

Agreement). Receipt of unearned premiums does not constitute payment of installments to LENDER, in full or in part. If the amount received is more than the

amount owed by Insured, any excess amount will be refunded to Insured; the minimum refund is $1.00 (no minimum in VA). If the amount received is less than the

amount owed by Insured, Insured will be responsible for the deficiency. Insured agrees that insurance companies may rely exclusively on LENDER's representations

about the financed policies. 

9. ASSIGNMENT. Insured may not assign any policy without LENDER's written consent. However, LENDER's consent is not needed to add mortgagees or other

persons as loss payees to financed policies. LENDER may transfer its rights under this Agreement to anyone without the consent of Insured.

10. AGENT OR BROKER. Insured agrees that the insurance Agent or Broker issuing the policies or through whom the policies were issued is not the agent of

LENDER, except for any action taken on behalf of LENDER with the express authority of LENDER, and LENDER is not bound by anything the Agent or Broker

represents to the Insured, orally or in writing, that is not contained in this Agreement. 

11. COLLECTION COSTS. Insured agrees to pay reasonable attorney fees, court costs, and other collection costs to LENDER to the extent permitted by law if this

Agreement is referred to an attorney or collection agent who is not a salaried employee of LENDER to collect money that Insured owes (not permitted in KY or MD).

12. LIABILITY.

13. GOVERNING LAW. This Agreement is governed by and interpreted under the laws of the state where the Insured resides, except for conflict of laws principles

thereof. If any court finds any part of this Agreement to be invalid, such finding shall not affect the remaining provisions of this Agreement. 

14. WARRANTY OF ACCURACY. The Insured represents and warrants that to the best of its knowledge (i) the insurance policies listed in the Schedule of Policies

are in full force and effect and that the Insured has not and will not assign any interest in the policies except for the interest of mortgagees and loss payees, (ii) that

unless disclosed on Page 1, none of the policies listed in the Schedule of Policies are for personal, family or household purposes, (iii) the Cash Down Payment and any

past due payments have been paid in full to the agent in cash or other immediately available funds, (iv) all information provided herein or in connection with this

Agreement is true, correct, complete and not misleading, (v) no proceeding in bankruptcy, receivership, insolvency or similar proceeding is instituted by or against

Insured, (vi) the Insured has no indebtedness to the insurers issuing the listed policies and none of those insurers have asserted any claims for payment against the

Insured, and (vii) there is no term or provision in any listed policies that would require LENDER to notify or obtain consent from any other party to effect cancellation

of such policies.

15. ADDITIONAL PREMIUMS. Funds paid by LENDER shall be applied to the premium amounts listed in this Agreement and Insured shall be responsible for any

additional premiums or other sums. Insured, or Agent/Broker, may request that LENDER finance additional policies and/or additional premium during the term of this

Agreement, and if LENDER agrees, this Agreement shall be deemed amended accordingly. Should LENDER assign an account number to further extensions of

credit, then a) this Agreement and loan documents identified by the assigned account number(s) shall be deemed to comprise a single and indivisible loan transaction,

b) Insured shall irrevocably appoint LENDER as its attorney in fact in connection with additional amount financed, c) default under any component of the transaction

shall constitute a default under the entire transaction, and d) unearned premium relating to any component of the transaction may be collected and applied to the entire

loan transaction balance.

16. AUDIT AND REPORTING FORM POLICIES. If any financed policies are auditable, reporting form policies or subject to retrospective rating, the Insured

agrees to fully comply with all audits and pay to the insurance company the earned premium computed in accordance with the policy provisions which is in excess of

the amount of premium advanced by LENDER and retained by the insurance company.

17. CORRECTIONS. LENDER may insert the names of the insurance companies and policy numbers, if this information is not known at the time Insured signs this

Agreement. LENDER is authorized to correct patent errors or omissions in this Agreement (not applicable in KY or VA).

The Agent or Broker executing this Agreement represents, warrants, and agrees: 

(1) The Insured has received a copy of this Agreement and has authorized this transaction, the Insured's signature is genuine and the cash down payment has been

received from the Insured, (2) the listed policies are in full force and effect, and the information contained in the Schedule of Policies including the premium amount is

correct, except for assigned risk policies where the actual premium amount may be unknown at this time, (3) the Agent or Broker is either the insurer's authorized policy

issuing agent or the broker placing the coverage directly with the insurer, except where the name of the Issuing Agent or General Agent is listed in the Schedule of

Policies, (4) no direct company bill, audit, or reporting form policies, or policies subject to retrospective rating or to minimum earned premium, are included, except as

previously disclosed in writing to LENDER, and the deposit of provisional premiums is not less than anticipated premiums to be earned for the full term of the policies,

(5) the policies can be cancelled by the Insured or LENDER (or its successors and assigns) with proper notice, and the unearned premiums will be computed on the

standard short rate or pro rata table except as previously disclosed in writing to LENDER, (6) to the best of the undersigned's knowledge and belief, there are no

bankruptcy, receivership, or insolvency proceedings affecting the Insured, (7) to hold LENDER, its successors and assigns harmless against any loss or expense

(including attorney fees) resulting from violations of these Representations and Warranties or from errors, omissions, or inaccuracies of Agent or Broker in preparing this

Agreement, (8) to pay all reasonable attorney fees, courts costs, and other collection costs incurred by LENDER in recovering amounts due from the Agent or Broker in

connection with any breach of these Agent or Broker Representations and Warranties, (9) to indemnify LENDER for any and all losses LENDER incurs as a result of

any error committed by the Agent or Broker in completing or failing to complete any portion of this Agreement, and (10) to hold in trust for LENDER any payments

made or credited to the insured through or to the undersigned directly or indirectly, actually or constructively by the insurance companies or LENDER and to pay the

monies as well as the unearned commissions to LENDER upon demand to satisfy the outstanding indebtedness of the Insured.

NC License #482. CA License #1850. VA License #PF146. California Borrowers: FOR INFORMATION CONTACT THE

DEPARTMENT OF FINANCIAL INSTITUTIONS, STATE OF CALIFORNIA

FIF0214Q

Where permissible by law, LENDER may pay some portion of the finance charge or other form of compensation to the Agent or Broker executing this Agreement for aiding in the administration of this Agreement (not applicable in VA). Any questions regarding this payment should be directed to the Agent or Broker.

Insured: Upstate Aerial Photography

Quote #: 000002725783 

Insured understands and agrees that LENDER is not liable to Insured or any person or entity upon the exercise of LENDER's right of cancellation, 

except in the event of willful or intentional misconduct by LENDER. This provision is not permitted in KY.