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Insurance Megastore
16050 S Tamiami Trail
Fort Myers, FL 33908
 
Phone: 239-225-6342
Fax: 239-334-6342

Insuring Florida
Residents & Businesses

Condominium Association
Insurance Quote Form
One Simple Form - takes only 2-3 Minutes!


 
Your Name:
Business Name:
Property Address:
City:
State: (Must be Florida)
Zip/Postal:
E-Mail (REQUIRED):
E-Mail
(again for accuracy):
Phone:
Fax (optional):
 
 
Dwelling Information
 
Year Building(s) Built:
 
# of Buildings:
 
# of Units per building (describe if varies):
 
Total of All Buildings Square footage:
 
Describe Occupancy:
(describe number of units, outbuildings, pools, playgounds, additional facilities and other ammenities.)
 
Underwriting & Descriptions
Use this section to describe average building features, give more details in remarks if necessary)

Type foundation: Slab
Crawlspace over slab
Pier & Post
Other (list in remarks)
 
Type finished basement, if any: None Full
25% 50% 75%
 
Type Roof: Shingle Wood Shake
Tar/Gravel Spanish Tile Metal Other
 
Type of Siding Brick   Vinyl
Wood   Aluminum
 
Number of stories: One Two
Three 4 or more
 
# of feet to nearest
fire hydrant:
# of miles to nearest
fire station:
 
Currently Insured? Yes No
Name of Carrier & how long insured?
 
Prior Claims? Yes No
Describe claims in detail:
 
Plumbing type: Copper Galvanized
Mixed (Copper/Galvanized)
 

 
Coverages:
 
Building Values: $ Contents $
Liability Cov. $ Deductible $
($250, $500, $1,000, etc.)
 
Other Coverage/Remarks
(describe any extra coverages needed such as business interruption, robbery, computers, etc.):
 
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