Business Name:
Premises Address:
City: Florida Zip Code:
Contact Name:
Phone #: Ext #:
Fax: Years in Business:
Email Address: (Required)
Condominium Association Insurance Coverage Desired:
Property Coverage Amount Desired: $
Property Coverage Deductible Amount: $
Liability Coverage Amount Desired:
Umbrella Coverage Amount Desired:
Year built:
Number of units:
Florida Condominium Information:
Building Value: $
Contents Value: $
Construction Type:
Sprinklers:
Central Alarm:
Claims in the last 3 years:
Description of claims:
Current Insurance Company:
Policy Expiration Date: (mm/dd/yyyy)
Additional Information or Comments
Click on the "Submit Quote Information" button below to send your
Florida Condominium Association Insurance quote request.**
**Information received from this Florida Condo Association Insurance quote
request form sent to M & L Insurance 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 Florida Condo Association insurance policy 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 your business to a Florida Condo Association
Insurance policy. We are licensed in Florida and will not provide condo
association insurance quotes for other states.
Premises Address:
City: Florida Zip Code:
Contact Name:
Phone #: Ext #:
Fax: Years in Business:
Email Address: (Required)
Condominium Association Insurance Coverage Desired:
Property Coverage Amount Desired: $
Property Coverage Deductible Amount: $
Liability Coverage Amount Desired:
Umbrella Coverage Amount Desired:
Year built:
Number of units:
Florida Condominium Information:
Building Value: $
Contents Value: $
Construction Type:
Sprinklers:
Central Alarm:
Claims in the last 3 years:
Description of claims:
Current Insurance Company:
Policy Expiration Date: (mm/dd/yyyy)
Additional Information or Comments
Click on the "Submit Quote Information" button below to send your
Florida Condominium Association Insurance quote request.**
**Information received from this Florida Condo Association Insurance quote
request form sent to M & L Insurance 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 Florida Condo Association insurance policy 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 your business to a Florida Condo Association
Insurance policy. We are licensed in Florida and will not provide condo
association insurance quotes for other states.
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M & L Insurance Agency of
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