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Home Warrantg
of America

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We've Got You Covered.

Home Warranty
of America

Laura Vetter
Account Executive
For Crders and Claims:

813.514.3255
lveiter(lilhwahomewarranty.corn

HwAHomewarranty.com
888.492 7359

Home Warrantg of America, lnc.

www.HWAHomeWa rrantg.com

888.492.7359

FLI

ZO14 BRI.;
F,2015

Applieent lnfsrmati*n

lffiiffir1t';,;* :::*

lf placing gour order bg phone or online, have information readg.

ICall for pricing ifover 5,000 sq. ft.]
Applicant {irst and last name

13-Month Home Warrantg

Covered propertg address

Cit!

State

lip

State

lip

Plan AccepUDecline

Mai ing Address {if different]

Cit!
Phone

I have been offered a Home Warrantg ofAmerica home warrantg for mU home and
undersland the terms/conditions of coverage.

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E

Email

Phone/Web Confirmation #

0rder Date

Buger

Se ler

Cl*sing lnferm*tion {if evail*ble j

Phone #

Compang Name

[losing compang

Email

0the'Part,

Gold

Platinum

Diamond I

Trade Call Fee per occutrence

or actual cost, whichever is less

osing #

uPt'onal
u.veraSe
Seller's Ccverage

eevered iterns*

lJnknown Insufi icient Maintenance

$60 Optional Seller's Coverage

*ptional EuSer's eever*ge

Unknown Pre-Existinp Conditions

Add on to All Plans:

Heatinq Sqstem/Furnace

ConditioningSqstem/Cooler 'l

Ductwork

Closino ap-"nt

Phone #

s Agent

$475 $500 $530

Air

Seller's Coverage

ofthis coverage. Slgnature

plon ond hercbg declines coverage. Applicont agreesto holdthe reol estate broker ond ogent
hormless in the event ofo subsequent m-.chonicdlfdilure which otherwise would hove been
covercd underthe watrontg plon.

Initiating agent name

represent?

Decline benefits

WaiYel PurchoseoJthiscoverogeisnotmdndototg.Appliconthasreviewedthehomewatrontg

Real Estate Agent lnformation

Who do gou

Buger's Coverage date of closing

rl
d

$75 GreenPlus

Covered sgstem or appliance will be replaced with an ENERGY STAR qualified product

Dishwasher, Refrigerator and Clothes Washer

Plumbinq Sqstem

Heating SUSlem replacement with 90% efficiencg model

Stoppages/Cloes

Water Heater replacement with Tankless Water Heater

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E
E

$49 Subrerranean Termite Treatment

$35 2nd Refrigerator

Ceillng Fans and Exhaust Fans

n
n

Door Bells, Burglar & FireAlarm Sqstems

$80 Additional Poo or Spa

$150 Sah Water Pool {must be purchasecl w th Pool/Spa ComboJ

Permanent Sump Pump

Water Heater lncludinp Tankless

[.]!llpool

Ba!h.-'|ub.,,..........

Electricai Sustem

fentral

Vacuum

'l

,t

Dishwasher

.t

Garbaqe Disposa

Buihln Microwave

Range/0ven/Cooktop
Trash Compactor ,*

"J
{

J
.l

$35 Freezer-Stand Alone

$150 Pool/Spa Combo

$85 We I Pump
$50 Septic Tank Pumping

$50 Septic Sgstem/Sewage Ejector Pump

Add on to Gold or Platinum:

$75 OrangePlus**

Add on to Gold:

Garaqe Door Sustem

Kitchen Refriseratorw,/ ce Maker

Washer/DrgerPaqKagg

E
E
E

$90 Roof Leak Repair

rl

$70 Premium Coverage**

Townhome/Condo

/Mobile Home

tr

Gold $455

Platinum $470

Re-Keq
13 SEER/R-410A Modif icatlons

select coveroge level

Prenirm Coverage^'

tr

Gold

$475

Platinum $500

Diamond $530

0ranqe Plus++

lncludes coverage for over 30 ltems traditiona lU not covered bg

basic home warranlu plans:

Sediment ln the water healer

.
.

Plumbing-Fixtures, faucets, shower heads, stoppages/c ogs

.
.

Code

Plus over 25 more itemsl

violations and permits up to $250

Unknown improperlg matched and/or installed sgstems
lncreases Professional Series appliances up to $2,500
ncreases toilet replacement up to $600

FL7 2014 BR0. Fr

R2015

Diamond $500

MuhipleFllls/Duplex/NewC0nstr!ctlon0r0ver5,A0Asq.lt. C011888.492.7359 ForPricing

Total 0ptional Seller's Coverage

Total 0ptional Buger's Coverage

Grand Total Coverage

See

contoclforspecfic

caveroge an campanents ond ports