South Florida Insurance Center

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Florida Condo and Renters

Quote Request Form

Name

 Mr.      Mrs.     Mr. and Mrs.    Ms. 

First Name  Middle Initial

Last Name                                    

Property Address

 Street Address:      

 Apt#                    

 City:                          Inside city limits? Yes  No 

 State:                   Florida  

 Zip Code:           

 County               

Condo Owners Only

New Purchase?

Yes  

No  

 Date of closing/purchase:   

Renters Only

New Lease?

Yes 

No   

 Lease effective date: 

Occupancy

  This apt/condo is or  will be: 

  Less than one month of UNoccupancy expected annually

Check any and all months the apt/condo will be NOT be occupied at any time during the        month. Your best guess, if you're not sure.

January February March April
May June July August
September October November December

If this is not a new purchase/lease, is it insured now? Yes  No 

If yes, are you being offered a renewal?  Yes  No    If no, what is the date of cancellation?

Tell Us About Your Unit

Cost to replace personal property  $

Cost to replace the interior (owned condos only)  $

This is the cost to replace floor, wall and ceiling coverings, as well as all cabinets and all other improvements

On what floor is your condo/apartment?

How many square feet does it have?

Protective Devices
Do you have dead bolt locks on all exterior doors, smoke detectors and a fire extinguisher inside your unit? Yes  No 
Sprinklers in each room? Yes  No 
Burglar Alarm?
Fire Alarm?
Hurricane Shutters?

Tell Us About Your Development

Name of your development:

  

Security in your development or building:

Check any security features below that apply to your development and/or building:
Locked gate at entrance or Limited Access Building? Yes  No
24 hr/day guards at  gate or building entrance?  Yes  No
24 hr/day patrolling guards? Yes  No

Tell Us About Your Building

Description of the building 

 Year Built   Townhouse? Yes  No  

 Number of Floors in the building   

 Number of units in the building 

Miscellaneous

Retired

Yes   No

Over age 55

Yes   No

Auto Insurance

 Who is your auto insurance company?

  (Home Insurance sometimes can be discounted if your car insurance is through certain carriers.)

Additional Information

  
How would you like your quotation sent?

E-mail  

  

Fax

  

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Contact Information

We welcome your inquiries and comments!

Telephone:         954-749-8045/800-883-9448 

Electronic mail:   SFICenter@aol.com