Flood Insurance Quote Request
Property Information
What is the address of the property you wish to get the flood insurance quote on? *
Enter street address, city, state, and zip VERY IMPORTANT we need the correct address to determine area elevation
Your answer
Is this a property you presently own? *
If you CURRENTLY OWN this property when did you purchase it?
estimate date as closely as possible, disregard if you do not own this property yet
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If you are in the process of purchasing what is the estimated closing date?
MM
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Do you currently have flood insurance on this property? *
If you currently have flood insurance on this property when does it expire?
MM
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DD
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YYYY
Is your MAILING address different than the property address? *
If you have a separate mailing address please provide it here:
Your answer
Name of Insured(s) *
If owned by individuals put all name(s) as they appear on the deed; If owned by a business put business name
Your answer
Your Phone Number *
We will ONLY call you in regards to this quote... we do not sell your information
Your answer
Your Email Address *
We use this to email your quote to you
Your answer
Date of Original Construction: *
Input year built
Your answer
Is a Mortgage Company requiring that you carry flood insurance? If yes, please provide their name and address:
Your answer
How many buildings are there at this location? *
(you purchase a separate flood insurance policy for each building on the property)
Your answer
Is this building located on Federal Land? *
Does this building have any extensions/additions other than an attached garage? *
Is the building in the course of construction? *
Is the building walled & roofed? *
How many Square Feet is this building? *
Your answer
What is the estimated Replacement Cost of the Building? *
(dollar value to rebuild this building)
Your answer
Are you the: *
Is this building a rental property? *
(do you rent this building to others)
Is this building a Condominium form of Ownership? *
Occupancy
The buildings purpose is: *
select one
Required
Please select Occupancy Type: *
Will the applicant live in this building more than 50% of the year? *
Foundation Type
Select Building Foundation Type: *
If you selected "Elevated on a Crawlspace", is the distance from the floor of the crawlspace to the top of the next floor MORE than 5 feet?
If you selected "Basement", is the basement floor below grade on all 4 sides?
Does your building have any certified Flood Vents?
Elevated Buildings Only
Answer this section if your building is elevated either on a crawlspace or piers
Is the building located over water?
Building is elevated by means of:
Enclosure Wall Construction
If you have a crawlspace is there any machinery, equipment, or appliances contained in the crawlspace?
Garage
Select Garage Type *
If you have a garage does it have more than 20 linear feet of finished wall, paneling etc?
If you have a garage is it used for any other purpose other than building access, parking of vehicles, or storage?
If you have a garage what size is it?
Either number of car spaces or square footage
Your answer
Please Indicate if you have any of the following items in your garage:
Elevator
Does this building contain an elevator? *
Building Type / Contents location
How many stories is your building? *
IMPORTANT: the floor of the crawlspace, or floor of the basement counts as one floor
Prior Flood Losses
In the past 10 years have you had any flood claims or Federal disaster relief payments? *
If "yes" please provide details:
Your answer
The Coverage you Would Like to Carry
How much coverage do you wish to carry on this building? *
(enter dollar value)
Your answer
How much contents(personal property) coverage would you like to carry for items contained in this building? *
(enter a dollar value; you may enter "0" if contents coverage is not desired)
Your answer
What deductible would you like to carry? *
Your answer
Elevation Certificate
Do you have an official Elevation Certificate for this building? *
Fill in any additional information in the REMARKS box below and then CLICK SEND!
Make sure the email you completed above is correct; also incude your phone number so we can call you if there are any questions.
Your answer
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