Florida Condo Insurance Quote

Personal Information

Name ✶

Street address ✶

City ✶

State ✶

ZIP ✶

Phone ✶

Email ✶

Best contact method ✶

E-mail

Phone

Occupation ✶

Date of birth ✶

SSN (optional)

Gender ✶

Male

Female

Bankruptcy or foreclosure in last 5 years? ✶

Yes

I give permission to run an insurance score ✶

Co-Owner

Name

Date of birth

Gender

Male

Female

Relationship

Condo Information

Is this your primary residence? ✶

Yes

Is this a new purchase? ✶

Yes

Closing date ✶

Is this a foreclosure or short sale? ✶

Yes

Community/Complex Name ✶

Property Address

Where is the property located? ✶

At the address above

At a different address

Street address ✶

City ✶

State ✶

ZIP ✶

Distance to fire hydrant ✶

Distance to fire station ✶

General

Year built ✶

Type ✶

Stories ✶

Construction ✶

Foundation ✶

Utilities

Age of electric ✶

yrs

Age of plumbing ✶

yrs

Age of heating ✶

yrs

Age of water heater ✶

yrs

Central A/C? ✶

Yes

Exterior

# of units in the building ✶

Roof Age

Garage

Type ✶

Size ✶

cars

Deck

Deck? ✶

Yes

Size ✶

sq ft

Porch

Screened-in Porch? ✶

Yes

Size ✶

sq ft

Interior

# of bathrooms ✶

# of bedrooms ✶

Living space ✶

sq ft

Type of flooring ✶

Do you have any pets? ✶

Yes

Type of pet

If you have dog(s), please list breed(s)

In-home business? ✶

Yes

Type of business

Monitored Security System? ✶

Yes

Security system purpose

Fire

Theft

Insurance Coverage Information

Inspections

Do you have a Wind Mitigation Inspection and/or a 4-Point Inspection? ✶

Yes

Upload inspection doc(s)

or email to membersinsurance [at] floridamic [dot] org

Current insurance

Does your homeowners association carry a master policy insuring the exterior of the building, including the roof? ✶

Yes

Upload copy of master policy

Or email to membersinsurance [at] floridamic [dot] org

I currently have a condo insurance policy (HO6) ✶

Yes

Insurance company ✶

Premium ✶

Renewal date ✶

Coverage amount ✶

Current policy declarations page (PDF)

This is optional but can help us with the quoting process

Claims History

Number of claims in past 5 years ✶

Prior coverage cancelled or non-renewed in the last 3 years? ✶

Yes

Desired Insurance Coverage

Optional Coverages

Earthquake

Flood

Identity Theft

Comments or questions

I understand that coverage cannot be bound or altered until the information has been confirmed by one of our representatives by phone or email. ✶

Subject

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CONDO INSURANCE QUOTE

Personal Information

Condo Information

Insurance Coverage Information