Flood

Last Name *

First Name *

Business Name *

Street Address *

City *

State *

Zip *

Phone Number *

Email Address *

Property Street Address *

City *

State *

Zip Code *

Occupancy Type

Building Type

Year Built *

Flood Map Zone Number

Current Elevation Certificate

If Yes, how many feet above sea level?

Community Flood Number

Distance to Body of Water *

Body of Water

How many stories is it? *

What is the construction type? *

Basement

What type of roof covering? *

Is the roof updated? *

If yes, what year?

Are there smoke detector at this location? *

Are there fire extinguishers? *

Are there circuit breakers? *

Is the electrical updated? *

How old is the heating/air conditioning? *

What is the energy source? *

Has the plumbing been updated?

If yes, what year was the plumbing updated?

Is the plumbing cooper?

Does the building have interior automatic fire sprinklers?

Is there a fire alarm?

Has the building been retrofitted or bolted?

Were there any loses or claims in the last 5 years?

If yes, what is the date, amount paid and description of each loss or claim?

Current Insurance Company *

How much are you paying now? *

What is the building coverage requested? *

What is the other structure coverage requested? *

What is the contents property coverage requested? *

Please let us know the best time to call and discuss your quote

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