FL Homeowner Insurance Quote

Full Name:
Address to be Insured:
City:    FLORIDA   Zip Code:
Email Address: (Required)
Home Phone: Work Phone: Ext.
How to Contact You:
Date of Birth:             (mm/dd/yyyy)

Do you currently have homeowner insurance?
Current Insurance Company:
Policy Expiration Date:          (mm/dd/yyyy)
Current Premium: $ per year
Coverage requested for:
Usage Type:
Years Lived at Address to be Insured:

Policy Endorsements

Dwelling ($ coverage limit):
Additional Structures ($ value):
Personal Property ($ value):

Personal Liability (each occurence):
Medical Payments (each person):
Deductible:
Hurricane Deductible:
Do you need Flood Insurance:

Florida Homeowner Insurance - Dwelling Information

Replacement Cost, Dwelling: Yes No
Replacement Cost, Contents: Yes No

Building Structure:
Year Dwelling Built:     Dwelling Square Feet:
Primary Heat Type:
Fireplace:
Garage:        Garage Size:
Alarm System:
Gated Community:         Hurricane Shutters:

Wiring Renovation:         Wiring Renovation Year:
Plumbing Renovation:     Plumbing Renovation Year:
Heating Renovation:       Heating Renovation Year:
Roofing Renovation:       Roofing Renovation Year:
Roof Type:                  Roof Age (years):
Dwelling Occupied By:
Swimming Pool:              Diving Board:
Trampoline:
Any Pets:
If you answered "Yes", please list type of pet.
Approved Fence:

Loss History

Did you have any losses, whether or not paid by insurance, during
the last 3 years, at this dwelling location or any other location?
If the answer to the previous question was "Yes", please explain below.

Date                            Type                            Description of Loss                 Amount of Loss



Additional Information or Comments

Click on the "Submit Quote Information" button below to send
your Florida Homeowner Insurance quote request.

Information received from this south Florida homeowner insurance quote form sent to Insurance Benefit Agency will be for our use only and will not be sold, given to or distributed to any other parties. A quote will be based on the homeowner insurance information provided and does not guarantee acceptance of the risk by us. The precise coverage afforded is subject to meeting underwriting guidelines, and the terms, conditions and exclusions of the policy as issued. By submitting this request you acknowledge that this is neither an offer to insure nor a guarantee of insurance. Completion of this form does not entitle you to Florida Homeowner insurance. We are licensed in Florida only and will not provide homeowners insurance quotes for other states.

We can offer cheaper Florida homeowners insurance quotes to the
following south Florida cities and counties: Miami-Dade County,
Broward County, Palm Beach County, Coral Gables, Kendall,
Richmond Heights, Pinecrest, Howard, Coral Way Village,
Westchester, Westwood Lakes, Brownsville, Sweetwater, Key
Biscayne, North Bay Village, Miami Beach, Miami Springs, Virginia
Gardens, Hialeah, El Portal, Miami Shores, Indian Creek, Surfside,
Bal Harbour, North Miami, Biscayne Park, Pinewood Park, Opa
Locka, Bunche Park, Hialeah Gardens, Palm Springs North, Carol
City, Miami, Norland, Ojus, Miami Lakes, Biscayne Gardens,
Hallandale, Sunny Isles Beach, Golden Beach, Aventura, Uleta,
Miramar, Pembroke Pines, North Miami Beach, Hallandale Beach,
Ives Estates, Pembroke Park, Hollywood, Dania Beach, Cooper City,
Davie, Weston, Plantation, Playland Isles, Melrose Park, Lauderhill,
Sunrise, Tamarac, Fort Lauderdale, Wilton Manors, Oakland Park,
Lauderdale Lakes, Sea Ranch Lakes, Pompano Beach, Margate,
Coral Springs, North Lauderdale, Lighthouse Point, Hillsboro Beach,
Coconut Creek, Deerfield Beach, Boca Raton, The Hamptons,
Highland Beach, Boca West, Delray Beach, Boca Pointe, Boynton
Beach, Lantana, Rainbow Lakes, Atlantis, Lake Worth, South Palm
Beach, Palm Springs, Greenacres, Wellington, Haverhill, Palm
Beach, Golden Lakes, Riviera Beach, Glen Ridge, West Palm Beach,
Lake Park, Royal Palm Beach, Jupiter, Juno Beach, North Palm
Beach, Loxahatchee, Belle Glade, Palm Beach Shores, South Miami,
Cutler Ridge, Princeton, Perrine, Naranja, Homestead, Florida City,
and Leisure City, FL