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X4628-FoldBlock
PRSRT STD
U.S. POSTAGE
PAID
MAILED FROM
ZIP CODE XXXXX
PERMIT NO. XXX
0 Outer Envelope (4.125” h x 9.5”)
1c, K / PMS Cool Grey 11U @ 60%
Window Size:
4.25” wide x 2.5” high
Window Placement
.875”Left
.625”Bottom
Indicia Placement:
.25” from right edge.
.25” from the top fold.
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E-Z PAY (see back of letter):
SIGNATURE (required)
XXXXX_FoldBlock
Homeowner Responsibility
The cost to replace a service
line averages $2,600.*
It is the homeowner’s
responsibility to pay for
exterior water service line
repair costs.
Nearly half of homeowners
have less than $500 or
nothing set aside for home
repair emergencies.**
Please take action now
to help protect your
finances from a water
service line breakdown.
PROTECTION INCLUDES:
• 
No service-call fee
• 
1-year guarantee on
covered parts and labor
• 
Emergency Repair
Hotline calls answered
at a US-based Call
Center of Excellence
Complete  return the attached
form in the postage-paid envelope
Call xxx-xxx-xxxx to speak with
a representative
For fastest processing, visit
www.URL.com and enter Promo
Code: Promo_Code
*National average repair costs as of June 2020.
**
2020 Biannual State of the Home Survey
conducted by The Harris Poll on behalf of
HomeServe.
Water Line Information
Partner Logo
ACCEPTANCE FORM
Please Respond by X/X/XXXX
Mailcode-xxxx
I authorize HomeServe to use account information from the enclosed check to make electronic fund transfers to automatically initiate debits to my bank account at the
frequency and in the amounts specified in the Payment Schedule, plus any applicable taxes, in connection with my payments for Product_Name. HomeServe
will only notify me if any change in taxes causes the charged/debited amount to vary more than ten percent. I understand the enclosed check itself will not be deposited
but rather used for account information. I understand that, regardless of the payment frequency I select, my optional coverage is based on an annual contract and will be
automatically renewed annually on the same payment terms I selected at the then-current renewal price (currently $X.XX per month, plus any applicable taxes). I have
the option to cancel this contract at any time without additional cost to me by calling 1-XXX-XXX-XXXX. I confirm that I am the homeowner and have read the information in this
package, understand there are limitations and exclusions, and meet the eligibility requirements for this coverage.
Prices include applicable state tax. Additional local tax may apply.
Payment Schedule:	 M_PR per month	 Q_PR per quarter	 A_PR per year
Mailcode
MR. SAMPLE A SAMPLE
MAIL_ADDRESS1
MAIL_ADDRESS2
MAIL_CITY, ST ZIP
Sample A. Sample_XXXXXXX Serv_Address1_XXXXXXX Serv_Address2_XXXXXXX Serv_City_XXX, ST Zip
Please correct name and address information below, if necessary, before submitting.
By providing my e-mail address, I request that I be e-mailed my current and future agreements and any related documents, and I acknowledge
that I can access these documents. I can change my preferences or request paper copies online or by calling HomeServe. The phone
number and e-mail address provided below are good ways to reach me.
Phone Number:
E-mail:
customer_no
Disclosure
Estimated Age of Original Home Structure
House_Age Years Old
FIRST_NAME LAST_NAME:
Please reply within 30 days
STATUS:
Not Covered
AOR NULL HEADER
since your house was built.
If House_Age is Null
replace entire green text
with: Unknown
Dear Sample A. Sample_XXXXXXX,
Your original water service line may be as old as your house, buried forHouse_Age years.
You are responsible for the exterior water service line on your property that provides fresh water to your home.
Environmental stresses may contribute to the deterioration of an exterior water service line. Weather changes
experienced across the country and in areas like ZIP_CODE can be unpredictable, just like water line breakdowns.
Temperature fluctuations may lead to ground shifting and corrosion, pipes can expand and contract, and bursts can
occur. Pipe failure can happen when we least expect it. The age of your pipes and pipe material can also be a
determining factor in water service line failure. Certain material can become brittle in temperature fluctuations and
your pipes may be the same age as your house on Serv_Address1_XXXXXXX.
It is important to understand your homeowner responsibility. The line that connects from your house to the property
boundary falls under your domain to fix, and normal wear and tear is not typically covered under basic homeowners
insurance. Lines are usually not inspected and are buried about 5 feet deep on nationwide average. You may never
know there is an issue until an emergency occurs, but the exterior water line belongs to you. And that’s why Partner_
Name has selected HomeServe to offer eligible customers optional Product_Name to help cover unexpected
costs from an exterior water line failure.
Details:
Benefits of protection include up to $X,XXX annually with multiple service calls/per service call with multiple calls
annually for covered repairs for only $X.XX per month (30-day waiting period includes a money-back guarantee). If your
water line suddenly fails, coverage from HomeServe provides you affordable help with no deductible, plus a trusted network
of local, licensed experts.
Please Take Action Now
Help protect your budget from costly water service line repairs.
Complete and return the form in the postage-paid envelope or call xxx-xxx-xxxx to enroll.
For fastest processing, visit www.website.com_xxxxxxxxxxxxxxxxxx and enter Promo Code: Promo_Code.
Promo Code: Promo_Code
CM NOTE: If URL will be turned Off/On, please
use this alternative to the yellow option:
Promo Code: Promo_Code
8.5”
12”
3.5”
fold
over
forward?
fold
fold
fold and 1 horiz and
1 vertical printed perf
14”
long
folds
at
3.5”
folds
at
3.5”
folds
at
3.5”
folds
at
3.5”
folds
in
half
7”
Flat size:12”w x 14”h
Finished Size: 8.5”x 3.5”
Color: 2c/2c: K, 30%Y / K + Pantone 286U
Stock: uncoated text
Window Size:
4.25” wide x 2.5” high
Window Placement
.375”Left
.625”Bottom
FPO
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12/20/21 1:07 PM
Exp. Date:
Card Number:
VISA		 MASTERCARD	 DISCOVER	 AMEX
X4628_FoldBlock
Important Questions  Answers
What am I responsible for?
As a homeowner, you are responsible for the exterior water
and sewer/septic service lines on your property. In some
towns, the service lines beyond the property boundary to the
main connection may remain the homeowner’s responsibility,
but are not included in this coverage.
Does this coverage include well lines?
Yes, coverage provides for repair or replacement of the
water service line on your property regardless of whether you
are connected to a city water main or private well.
Does my homeowners insurance or local utility company
cover this?
Most basic homeowners insurance policies and local utility
companies do not cover repair or replacement of the water
or sewer/septic service lines.
Who is eligible for coverage?
A residential homeowner with sole responsibility for the
exterior water and sewer/septic service lines may be eligible
for coverage. Recreational vehicles and properties used for
commercial purposes are not eligible for coverage. If you live
in a development community with a condominium, co-op or
homeowners association, your exterior water and sewer/
septic service lines may not be an individual homeowner’s
responsibility, so please check with your association before
accepting this coverage.
What should I know about this coverage?
What’s covered: Coverage provides, up to the benefit
amount, for the covered cost to repair or replace a leaking or
permanently blocked exterior water or sewer/septic service
line damaged due to normal wear and tear, not accident or
negligence. Exterior Water Service Line - The water or well
service line supplying fresh water to your home from your
property boundary to the external wall of your home. Exterior
Sewer/Septic Service Line - The line that takes wastewater
away from the external wall of your home up to either your
property boundary or the point of connection to the septic
tank on your property.
Not covered: Septic tanks, leaching fields, pumps, grinders
and damage or negligence caused by you or others.
Additional exclusions apply. To see full Terms and Conditions
with complete coverage and exclusion details prior to
enrolling call 1-877-444-7750 or go to 7B_Website.
When can I make a service call?
Your plan starts the day your form is processed, and there is
an initial 30-day waiting period before you can make a service
call, giving you 11 months of coverage during the first year.
This prevents service calls on pre-existing conditions and
helps keep the coverage affordable.
What is the cancellation policy?
You may cancel within 30 days of your start date for a full
refund; cancellations after the first 30 days will result in a
pro-rata refund less any claims paid (where applicable).
What is the term of my service agreement?
Your coverage is based on an annual contract. For E-Z Pay,
creditcardordebitcardcustomers:regardlessofthepayment
frequency you select, your service agreement will be
automatically renewed annually on the same payment terms
selected, at the then-current renewal price. Your coverage
will remain in effect unless you call to discontinue.
What is E-Z Pay?
E-Z Pay is a paperless and stress-free way to pay for your
coverage. Payments are automatically debited from the
bank/checking account of your choice as your payment
becomes due, at no additional cost.
What quality of repair can I expect?
Local, licensed and insured plumbers perform all covered
repairs, which are guaranteed against defects in materials
and workmanship for one year.
Who is HomeServe?
HomeServeisanindependentcompanyprovidingemergency
homerepairservicesandprotectionsolutionstohomeowners
across the U.S. If you have questions about this mailing or
to be removed from our mailing list, call 1-855-321-9871.
SIGNATURE (required)
SIGNATURE (required)
The illustration shows the exterior water service line
that is your responsibility as a homeowner. Also shown
are repairs that are commonly performed on this line
and how much a licensed and insured contractor
would typically charge a homeowner for repairs.
Give yourself less to worry about.
With Product_Name_xxxxxxxxxxxxx from
HomeServe, it’s not something you have to worry
about; you’ll benefit from a priority response and no bill
to pay for covered repairs, up to $X,XXX per year/
service call.
Know Your Responsibility
The service line beyond the property boundary is an
additional responsibility of the homeowner, but it is not included
in this coverage.
‡
National average repair costs as of June 2020. No charge for covered
repairs up to your annual/service call benefit amount.
WATER
MAIN
TYPICAL
HOMEOWNER’S
RESPONSIBILITY
WATER
SERVICE LINE
PROPERTY
BOUNDARY
Replace water
service line
(26–100 ft.) $2,661‡
Plan Members:
$0.00‡
Repair water
service line $490‡
Plan Members:
$0.00‡
Please respond by X/X/XXXX
Complete  return the attached form
in the postage-paid envelope.
Call xxx-xxx-xxxx to speak with
a representative
For fastest processing, visit
www.URL.com and enter Promo Code:
Promo_Code
CREDIT/DEBIT CARD: I authorize HomeServe to charge my first and all
future payments, plus any applicable taxes, for Product_Name_
XXXXXXXXXXXXX to my credit/debit card at the frequency specified. I understand
that, regardless of the payment frequency I select, my optional coverage is based on
an annual contract and will be automatically renewed annually on the same payment
terms I selected at the then-current renewal price (currently $X.XX per month,
plus any applicable taxes). I have the option to cancel this contract at any time
without additional cost to me by calling 1-XXX-XXX-XXXX. I confirm that I am the
homeowner and have read the information in this package, understand there are
limitations and exclusions, and meet the eligibility requirements for this coverage.
ONE-TIME CHECK OR MONEY ORDER: I have enclosed my check or money order
for my payment of A_PR, which includes applicable taxes, for optional
Product_Name_XXXXXXXXXXXXX. I confirm that I am the homeowner and
have read the information in this package, understand there are limitations and
exclusions, and meet the eligibility requirements for this coverage.
Please be sure to sign and date your check or money order in the amount of
A_PR, which includes applicable taxes, for this coverage.
PLEASE MAKE PAYABLE TO HOMESERVE
M_PR per month Q_PR per quarter A_PR per year
Prices include applicable state tax. Additional local tax may apply.
Mailcode
MatchbackID	Mailcode
8.5”
12”
3.5”
fold
fold
14”
long
folds
at
3.5”
folds
at
3.5”
folds
at
3.5”
folds
at
3.5”
folds
in
half
7”
fold and 1 horiz and 1 vertical
printed perf
fold
fold
.25”
.25”
.375”
.375”
FPO
FPO
X4628_FoldBlock_LtrAtApp.indd 2
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12/20/21 1:07 PM

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X4628_FoldBlock_PKG_v25.pdf

  • 1. X4628-FoldBlock PRSRT STD U.S. POSTAGE PAID MAILED FROM ZIP CODE XXXXX PERMIT NO. XXX 0 Outer Envelope (4.125” h x 9.5”) 1c, K / PMS Cool Grey 11U @ 60% Window Size: 4.25” wide x 2.5” high Window Placement .875”Left .625”Bottom Indicia Placement: .25” from right edge. .25” from the top fold. X4628_FoldBlock_LtrAtApp_OE.indd 1 X4628_FoldBlock_LtrAtApp_OE.indd 1 9/23/21 5:12 PM 9/23/21 5:12 PM
  • 3. E-Z PAY (see back of letter): SIGNATURE (required) XXXXX_FoldBlock Homeowner Responsibility The cost to replace a service line averages $2,600.* It is the homeowner’s responsibility to pay for exterior water service line repair costs. Nearly half of homeowners have less than $500 or nothing set aside for home repair emergencies.** Please take action now to help protect your finances from a water service line breakdown. PROTECTION INCLUDES: • No service-call fee • 1-year guarantee on covered parts and labor • Emergency Repair Hotline calls answered at a US-based Call Center of Excellence Complete return the attached form in the postage-paid envelope Call xxx-xxx-xxxx to speak with a representative For fastest processing, visit www.URL.com and enter Promo Code: Promo_Code *National average repair costs as of June 2020. ** 2020 Biannual State of the Home Survey conducted by The Harris Poll on behalf of HomeServe. Water Line Information Partner Logo ACCEPTANCE FORM Please Respond by X/X/XXXX Mailcode-xxxx I authorize HomeServe to use account information from the enclosed check to make electronic fund transfers to automatically initiate debits to my bank account at the frequency and in the amounts specified in the Payment Schedule, plus any applicable taxes, in connection with my payments for Product_Name. HomeServe will only notify me if any change in taxes causes the charged/debited amount to vary more than ten percent. I understand the enclosed check itself will not be deposited but rather used for account information. I understand that, regardless of the payment frequency I select, my optional coverage is based on an annual contract and will be automatically renewed annually on the same payment terms I selected at the then-current renewal price (currently $X.XX per month, plus any applicable taxes). I have the option to cancel this contract at any time without additional cost to me by calling 1-XXX-XXX-XXXX. I confirm that I am the homeowner and have read the information in this package, understand there are limitations and exclusions, and meet the eligibility requirements for this coverage. Prices include applicable state tax. Additional local tax may apply. Payment Schedule: M_PR per month Q_PR per quarter A_PR per year Mailcode MR. SAMPLE A SAMPLE MAIL_ADDRESS1 MAIL_ADDRESS2 MAIL_CITY, ST ZIP Sample A. Sample_XXXXXXX Serv_Address1_XXXXXXX Serv_Address2_XXXXXXX Serv_City_XXX, ST Zip Please correct name and address information below, if necessary, before submitting. By providing my e-mail address, I request that I be e-mailed my current and future agreements and any related documents, and I acknowledge that I can access these documents. I can change my preferences or request paper copies online or by calling HomeServe. The phone number and e-mail address provided below are good ways to reach me. Phone Number: E-mail: customer_no Disclosure Estimated Age of Original Home Structure House_Age Years Old FIRST_NAME LAST_NAME: Please reply within 30 days STATUS: Not Covered AOR NULL HEADER since your house was built. If House_Age is Null replace entire green text with: Unknown Dear Sample A. Sample_XXXXXXX, Your original water service line may be as old as your house, buried forHouse_Age years. You are responsible for the exterior water service line on your property that provides fresh water to your home. Environmental stresses may contribute to the deterioration of an exterior water service line. Weather changes experienced across the country and in areas like ZIP_CODE can be unpredictable, just like water line breakdowns. Temperature fluctuations may lead to ground shifting and corrosion, pipes can expand and contract, and bursts can occur. Pipe failure can happen when we least expect it. The age of your pipes and pipe material can also be a determining factor in water service line failure. Certain material can become brittle in temperature fluctuations and your pipes may be the same age as your house on Serv_Address1_XXXXXXX. It is important to understand your homeowner responsibility. The line that connects from your house to the property boundary falls under your domain to fix, and normal wear and tear is not typically covered under basic homeowners insurance. Lines are usually not inspected and are buried about 5 feet deep on nationwide average. You may never know there is an issue until an emergency occurs, but the exterior water line belongs to you. And that’s why Partner_ Name has selected HomeServe to offer eligible customers optional Product_Name to help cover unexpected costs from an exterior water line failure. Details: Benefits of protection include up to $X,XXX annually with multiple service calls/per service call with multiple calls annually for covered repairs for only $X.XX per month (30-day waiting period includes a money-back guarantee). If your water line suddenly fails, coverage from HomeServe provides you affordable help with no deductible, plus a trusted network of local, licensed experts. Please Take Action Now Help protect your budget from costly water service line repairs. Complete and return the form in the postage-paid envelope or call xxx-xxx-xxxx to enroll. For fastest processing, visit www.website.com_xxxxxxxxxxxxxxxxxx and enter Promo Code: Promo_Code. Promo Code: Promo_Code CM NOTE: If URL will be turned Off/On, please use this alternative to the yellow option: Promo Code: Promo_Code 8.5” 12” 3.5” fold over forward? fold fold fold and 1 horiz and 1 vertical printed perf 14” long folds at 3.5” folds at 3.5” folds at 3.5” folds at 3.5” folds in half 7” Flat size:12”w x 14”h Finished Size: 8.5”x 3.5” Color: 2c/2c: K, 30%Y / K + Pantone 286U Stock: uncoated text Window Size: 4.25” wide x 2.5” high Window Placement .375”Left .625”Bottom FPO X4628_FoldBlock_LtrAtApp.indd 1 X4628_FoldBlock_LtrAtApp.indd 1 12/20/21 1:07 PM 12/20/21 1:07 PM
  • 4. Exp. Date: Card Number: VISA MASTERCARD DISCOVER AMEX X4628_FoldBlock Important Questions Answers What am I responsible for? As a homeowner, you are responsible for the exterior water and sewer/septic service lines on your property. In some towns, the service lines beyond the property boundary to the main connection may remain the homeowner’s responsibility, but are not included in this coverage. Does this coverage include well lines? Yes, coverage provides for repair or replacement of the water service line on your property regardless of whether you are connected to a city water main or private well. Does my homeowners insurance or local utility company cover this? Most basic homeowners insurance policies and local utility companies do not cover repair or replacement of the water or sewer/septic service lines. Who is eligible for coverage? A residential homeowner with sole responsibility for the exterior water and sewer/septic service lines may be eligible for coverage. Recreational vehicles and properties used for commercial purposes are not eligible for coverage. If you live in a development community with a condominium, co-op or homeowners association, your exterior water and sewer/ septic service lines may not be an individual homeowner’s responsibility, so please check with your association before accepting this coverage. What should I know about this coverage? What’s covered: Coverage provides, up to the benefit amount, for the covered cost to repair or replace a leaking or permanently blocked exterior water or sewer/septic service line damaged due to normal wear and tear, not accident or negligence. Exterior Water Service Line - The water or well service line supplying fresh water to your home from your property boundary to the external wall of your home. Exterior Sewer/Septic Service Line - The line that takes wastewater away from the external wall of your home up to either your property boundary or the point of connection to the septic tank on your property. Not covered: Septic tanks, leaching fields, pumps, grinders and damage or negligence caused by you or others. Additional exclusions apply. To see full Terms and Conditions with complete coverage and exclusion details prior to enrolling call 1-877-444-7750 or go to 7B_Website. When can I make a service call? Your plan starts the day your form is processed, and there is an initial 30-day waiting period before you can make a service call, giving you 11 months of coverage during the first year. This prevents service calls on pre-existing conditions and helps keep the coverage affordable. What is the cancellation policy? You may cancel within 30 days of your start date for a full refund; cancellations after the first 30 days will result in a pro-rata refund less any claims paid (where applicable). What is the term of my service agreement? Your coverage is based on an annual contract. For E-Z Pay, creditcardordebitcardcustomers:regardlessofthepayment frequency you select, your service agreement will be automatically renewed annually on the same payment terms selected, at the then-current renewal price. Your coverage will remain in effect unless you call to discontinue. What is E-Z Pay? E-Z Pay is a paperless and stress-free way to pay for your coverage. Payments are automatically debited from the bank/checking account of your choice as your payment becomes due, at no additional cost. What quality of repair can I expect? Local, licensed and insured plumbers perform all covered repairs, which are guaranteed against defects in materials and workmanship for one year. Who is HomeServe? HomeServeisanindependentcompanyprovidingemergency homerepairservicesandprotectionsolutionstohomeowners across the U.S. If you have questions about this mailing or to be removed from our mailing list, call 1-855-321-9871. SIGNATURE (required) SIGNATURE (required) The illustration shows the exterior water service line that is your responsibility as a homeowner. Also shown are repairs that are commonly performed on this line and how much a licensed and insured contractor would typically charge a homeowner for repairs. Give yourself less to worry about. With Product_Name_xxxxxxxxxxxxx from HomeServe, it’s not something you have to worry about; you’ll benefit from a priority response and no bill to pay for covered repairs, up to $X,XXX per year/ service call. Know Your Responsibility The service line beyond the property boundary is an additional responsibility of the homeowner, but it is not included in this coverage. ‡ National average repair costs as of June 2020. No charge for covered repairs up to your annual/service call benefit amount. WATER MAIN TYPICAL HOMEOWNER’S RESPONSIBILITY WATER SERVICE LINE PROPERTY BOUNDARY Replace water service line (26–100 ft.) $2,661‡ Plan Members: $0.00‡ Repair water service line $490‡ Plan Members: $0.00‡ Please respond by X/X/XXXX Complete return the attached form in the postage-paid envelope. Call xxx-xxx-xxxx to speak with a representative For fastest processing, visit www.URL.com and enter Promo Code: Promo_Code CREDIT/DEBIT CARD: I authorize HomeServe to charge my first and all future payments, plus any applicable taxes, for Product_Name_ XXXXXXXXXXXXX to my credit/debit card at the frequency specified. I understand that, regardless of the payment frequency I select, my optional coverage is based on an annual contract and will be automatically renewed annually on the same payment terms I selected at the then-current renewal price (currently $X.XX per month, plus any applicable taxes). I have the option to cancel this contract at any time without additional cost to me by calling 1-XXX-XXX-XXXX. I confirm that I am the homeowner and have read the information in this package, understand there are limitations and exclusions, and meet the eligibility requirements for this coverage. ONE-TIME CHECK OR MONEY ORDER: I have enclosed my check or money order for my payment of A_PR, which includes applicable taxes, for optional Product_Name_XXXXXXXXXXXXX. I confirm that I am the homeowner and have read the information in this package, understand there are limitations and exclusions, and meet the eligibility requirements for this coverage. Please be sure to sign and date your check or money order in the amount of A_PR, which includes applicable taxes, for this coverage. PLEASE MAKE PAYABLE TO HOMESERVE M_PR per month Q_PR per quarter A_PR per year Prices include applicable state tax. Additional local tax may apply. Mailcode MatchbackID Mailcode 8.5” 12” 3.5” fold fold 14” long folds at 3.5” folds at 3.5” folds at 3.5” folds at 3.5” folds in half 7” fold and 1 horiz and 1 vertical printed perf fold fold .25” .25” .375” .375” FPO FPO X4628_FoldBlock_LtrAtApp.indd 2 X4628_FoldBlock_LtrAtApp.indd 2 12/20/21 1:07 PM 12/20/21 1:07 PM