Florida Umbrella Insurance Quote

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6810 E Hillsborough Ave
Tampa, Florida 33610

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Insurance Quote Request

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Eligibility Questions

How many motorized vehicles licensed for road use in your household? ✶

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How many residential properties in your household? ✶

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How many watercraft, OTHER than personal watercraft (WaveRunners, Jet Skis, etc.), are in your household? ✶

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How many personal watercraft (Jet Skis, WaveRunners etc.) in your household? ✶

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What is the total number of drivers? (Include drivers with a learner's permit or valid driver's license)? ✶

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How many drivers are under the age of 22? (Include drivers with a learner's permit) ✶

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How many drivers are age 70 and over? ✶

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Are any drivers age 80 or older? ✶

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How many moving violations have ALL drivers had within the last 3 years? Include DWI/DUI violations within the last 5 years? ✶

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How many at-fault accidents have all drivers had in the last 3 years? ✶

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How many antique, classic and/or collectible vehicles are in your household? ✶

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How many residential properties owned or rented by you or any member of your household are located outside U.S. (including U.S. territories and possessions), Canada, or Puerto Rico? ✶

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How many acres of land owned or leased (including partial ownership)? ✶

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How many drivers have been licensed less than one year, have a learner's permit, or have a non- U.S. driver's license? ✶

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How many driving incidents have all drivers ages 21 and under had within the last 3 years? ✶

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How many driving incidents have all drivers ages 80 and over had within the last 3 years? ✶

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How many alcohol/drug related driving incidents have all drivers had in the last 5 years? ✶

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Do you elect to purchase Excess Uninsured/Underinsured Motorists coverage? ✶

Yes No

What underlying homeowners liability or comprehensive personal liability limits do you agree to maintain? ✶

Which of the following MINIMUM REQUIRED LIMITS OF AUTOMOBILE LIABILITY do all drivers agree to maintain as a condition of coverage for all licensed vehicles, that are owned (titled or registered to), leased, rented, operated or acquired during the policy period by you or any member of your household? ✶

Have you or any other driver had an arrest, citation or conviction for reckless driving, careless driving with at least 4 points assigned, negligent driving and/or had a driver's license suspended (for reasons other than driving under the influence of alcohol or drugs), revoked or refused in the last 5 years? ✶

Yes No

Have you or any member of your household been indicted, charged with or convicted of a felony within the last 5 years? ✶

Yes No

Are you or any member of your household recognized nationally or locally as a celebrity or famous person (i.e., professional entertainer, athlete, media personality, etc.)? ✶

Yes No

Have you or any member of your household had a liability loss greater than $50,000 in the past 5 years or is there any open liability claim or lawsuit pending against you or any member of your household? ✶

Yes No

Does any other member of your household or person residing in your household have a Personal Umbrella policy with RLI Insurance Company other than this policy? ✶

Yes No

Has any one driver had more than 3 moving violations within the last 3 years? (Include DWI/DUI incidents within the last 5 years) ✶

Yes No

Has any one driver ages 21 and under and/or 80 and over had more than one driving incident within the past 3 years? ✶

Yes No

Are you pursuing umbrella coverage for installation of solar panels? ✶

Yes No

Does the solar contract require a Commercial General Liability (CGL) policy? ✶

Yes No

Comments

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

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About Us

Members Insurance Center is an independent insurance agency located in Tampa, Florida.

Give us a call, stop by, or request a quote online to find out how much we can save you on your insurance.

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6810 E Hillsborough Ave
Tampa, Florida 33610
888-238-7511
813-622-6449
"Email Us" <membersinsurance [at] floridamic [dot] org>
membersinsurance [at] floridamic [dot] org
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