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Get a Homeowners Insurance Quote

Get a Homeowners Insurance Quote

Get a Homeowners Insurance QuoteJen Johnson2023-08-06T00:11:49-04:00

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Thank you for your interest in receiving a quote from My Florida Insurance. This form should only take about 5-10 minutes to complete. Don't worry if you don't have everything. You can always click the "Save and continue later" button below. We'll email you a private link to pick up where you left off.
Types of Insurance*
MM slash DD slash YYYY
Name*
Can we text you?*
Consent is not required as a condition of purchase. Message frequency will vary. Message and data rates may apply. Reply HELP for help or STOP to cancel. Privacy Policy.

Current Address

Mailing Address*
Current Address*

Primary Applicant

Date of Birth*
Motorcycle Endorsement?
Is there a Co-Applicant?

Co-Applicant

Co-Insured Name*
Co-Insured Date of Birth*
Co-Insured Motorcycle Endorsement?

Property Information

Property Address*
Is property titled in a name Other Than your personal name(s)?*
Example: Trust, LLC, Corporation, Partnership, etc.
Is this a New Purchase?*
MM slash DD slash YYYY
Why we need this: We represent many different insurance companies and we don't want to quote your insurance with the same carrier.
You may upload up to 5 policy documents. Only .pdf file type accepted.
Drop files here or
Accepted file types: pdf, Max. file size: 12 MB, Max. files: 5.
    Will there be a Mortgage?*
    Have Dogs?
    Have you had any insurance lapse (30 days or more), cancel, or non-renew in the last 3 years?*

    Home Information

    Has there been any updates to the Roof, Plumbing, Heating, or Electrical?
    How many years old is the water heater? If you don't know, enter Unknown.
    Solar Panels?
    The following discounts are available. Please check all that apply.
    Examples: elevator, backup generator, water shut off monitoring, etc.
    If you would like to attach any pictures of your home inside and/or outside, please do so here.
    Drop files here or
    Max. file size: 3 MB, Max. files: 6.

      Scheduled Items

      Most home insurance policies allow you to schedule valuable items to your policy such as jewelry, fine art, firearms, antiques, bikes, cameras, certain electronics, collectibles, musical instruments, silverware, etc. If you would like to include any of these items, please do so below. If an item is ineligible for scheduling to your policy we will let you know.
      Do you have any items you would like to schedule to your policy?
      List of Scheduled Items
      Item Description
      Item Value ($)
      Do you have an appraisal
       

      Additional Drivers

      Are there additional drivers in your household?

      Additional Driver 1

      1. Driver Name*
      1. Driver Date of Birth*
      Add 2nd Driver

      Additional Driver 2

      2. Driver Name*
      2. Driver Date of Birth*
      Add 3rd Driver

      Additional Driver 3

      3. Driver Name*
      3. Driver Date of Birth*
      Add 4th Driver

      Additional Driver 4

      4. Driver Name*
      4. Driver Date of Birth*

      Vehicle 1

      1. Ownership
      1. Vehicle Financed
      1. Vehicle is used for*
      Add 2nd Vehicle

      Vehicle 2

      2. Ownership
      2. Vehicle Financed
      2. Vehicle is used for*
      Add 3rd Vehicle

      Vehicle 3

      3. Ownership
      3. Vehicle Financed
      3. Vehicle is used for*
      Add 4th Vehicle

      Vehicle 4

      4. Ownership
      4. Vehicle Financed
      4. Vehicle is used for*
      Add 5th Vehicle

      Vehicle 5

      5. Ownership
      5. Vehicle Financed
      5. Vehicle is used for*
      Add 6th Vehicle

      Vehicle 6

      6. Ownership
      6. Vehicle Financed
      6. Vehicle is used for*

      Special Motorcycle Coverages

      Enhanced Injury Protection
      Physical Damage
      Roadside Assistance
      Carried Contents
      Transport Trailer Coverage?

      Boat Information

      This is the ID number assigned to your boat by the state.
      Insure the Trailer?

      Umbrella Coverage Information

      Any drivers under age 25?
      Any drivers over age 75?

      Wrapping Up

      Any Claims in the Past Three (3) Years?*
      Any prior flood losses for your property?
      Do you need any SR-22 filings?*
      Enter None if no prior insurance.
      Drop files here or
      Max. file size: 12 MB.
        Consent*
        Like most insurance agencies, we use information from you and other sources, such as your driving and claims histories, insurance score, and other factors to calculate an accurate rate for your insurance. New or updated information may be used to calculate your renewal premium.
        This field is for validation purposes and should be left unchanged.
        My Florida Insurance

        My Florida Insurance

        28292 Industrial Rd #2
        Bonita Springs, Florida 34135
        Phone: 239-221-0522
        Fax: 239-908-4008
        My Florida Insurance

        My Florida Insurance

        28292 Industrial Rd #2
        Bonita Springs, Florida 34135
        Phone: 239-221-0522
        Fax: 239-908-4008

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        DISCLAIMER: Informational statements regarding insurance coverage are for general description purposes only. These statements do not amend, modify or supplement any insurance policy. Read your policy or consult with your agent for details. Your eligibility for particular products and services is subject to final underwriting and acceptance by the insurance company providing such products or services.

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        28292 Industrial Rd #2
        Bonita Springs Florida 34135

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