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Declarations: <br />Other Charges <br />Form: SC 00 01 10 18 10 <br />States laws and regulations may require you to pay taxes, fees, surcharges or other costs. We’ve listed those <br />charges below <br />DESCRIPTION COST <br />Other Premiums <br />Policy Base Premium $246 <br />Terrorism Premium $12 <br />Fees, Surcharges and Taxes <br />California Fair Plan Assessment $0 <br />Docusign Envelope ID: 9DF92A24-B534-85BA-8088-342315DF1839