I am looking for a market to write an H0-6 for a vacation/second home in Florida. Address is 7601 E. Treasure DR North Bay Village, FL 33141-4391 Please, help
Hello Tucker,
Pls fill out the following form and either e-mail or fax back.
Thank you.
Joe Cruz
239. 455-6605
J I Cruz Insurance Agency
3888 Mannix Drive, Suite 320 Naples, FL 34114
Phn: 239. 455-6605 Fax: 239. 455-2129 jcruz@allstate.com
Homeowners Insurance Quote Form
Date: ____________________ Renewal _____ New Purchase _____ Refinance _____
Primary _____ Secondary_____ Rented to Others _____ Condo _____ Renters _____
E-mail Addresses:
Name______________________________________ DOB_____________ SS#__________________ Optn_______
Name______________________________________ DOB_____________ SS#__________________ Optn_______
Subject Address _______________________________________________________________________________
Mailing Address ________________________________________________________________________________
Home # _________________________ Cell # __________________________ Office # ______________________
Usage: 2dary:Length/Frequency______________________ Seasonal/How Long ______________ Rented _______
Year Built ____________ Construction Material ________________________ Roofing Material _________________
Roof Geometry ______________ Total # of Floors _______ Subject Floor ________ 2nd Floor Material ___________
#BR ______ #BA ______ # Car Garage (Attached/built-in) ____________________ SF Under Air ______________
Pool _____ Lanai/Fenced________ Monitored Alarm/Co_____________________ Hurricane Shutters/Cert________
Gated _______ Distance to Fire Station ________ Distance to Fire Hydrant _________
Protection Class ________ BCEG Code ________ Animals _____________________________________________
Current Coverages:
Dwelling ___________________ Content ____________ AOP Ded ________ Wind Ded ______ Premium _______
Present Ins Co ____________________________________ Policy No. __________________ Exp Date _________
Past Claims (Dates/$) ___________________________________________________________________________
New Purchase:
Closing Date _________________ Mrtge Broker/Company/Phn __________________________________________
Mortgagee Clause ________________________________________________________________ Escrowed? ____
_____________________________________________________________________________________________
Loan # ______________________Referred by/Co _____________________________ Phone _________________
Title Co ___________________________________ Contact _____________________ Phone _________________