Neighbors Insurance - Commercial and Personal Insurance in Boca Raton, Florida

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Home Insurance Quotation Form

Contact Information

 *  Indicates Required Fields
Name:   * 
Home Phone:
like 561-555-1212		   * 
Work Phone:
like 561-555-1212
Fax Number:
like 561-555-1212
Mobile Phone:
like 561-555-1212
Email Address:   * 
(Please be sure you provide a valid email address.)

Mailing Address:
Address:  
City/State/County:  

Location Address:
Address:  
City/State/County:  

Property Information:
Property Type: Single Family Condo TownHouse Coach
Year Built:  
Total Sq Ft Under Air  
Total Number of Stories  
Construction Type Masonry Frame WoodSiding Brick
Type of Roof Covering Asphalt Concrete Tile Wood Shake Tin Flat
Dwelling Use Primary Secondary Seasonal
Months Occupied  
No. of Miles from a Fire Station  
No. of Feet from a Fire Hydrant  
Garage None Attached Detached
Carport Yes No
Balcony Yes No
Breezeway Yes No
Wood Deck None Small Medium Large
Open Porch None Small Medium Large
Covered Porch None Small Medium Large
Pool None Small Medium Large
Pool Enclosure Yes No
Fireplace Yes No Single Double
Tennis Court Yes No
Heating Electric Gas
No. of Full Bathrooms
No.of Half Bathrooms
Kitchen Standard Custom Designer
Bathrooms Standard Custom Designer
Solar Panels Yes No
Central Vacuum System Yes No
Intercom System Yes No

Safety Device Credits:
Central Station Burglar Alarm: Yes No
Central Station Fire Alarm: Yes No
Fire Sprinkler System: Yes No

Current / Requested Coverage Limits:
Coverage A - Dwelling:
Coverage B - Other Structures
Coverage C - Personal Property
Coverage D - Loss of Use
Coverage E - Liability
Coverage F - Medical Payments
Hurricane Deductible 2% 5% 10%
All Other Peril Deductible $500 $1,000 $2,500
Flood Insurance Yes No

Other Information
Prior Insurance Yes No
New Home Purchase Yes No
Rented To Others Yes No
Golf Carts Yes No
Trampoline Yes No
Dog Yes No
Exotic Animals Yes No

Optional Valuable Articles (Personal Property)
Jewelry Yes No
Fine Art Yes No
Furs Yes No
Silverware Yes No
Musical Instruments Yes No
Other Collectible Items Yes No
Misc.