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Important
Note:
This
document is made available to you for your convenience. This document is
only a quote application and does not pretend to cover any of the of the
terms and exclusions of the policy herein presented. This document is not
your policy and does not modify or extend the cover of this policy. the
insurance company, emitter of the quote/policy is subjected to all the
exclusions and terms of the policy. If there are any discrepancy between
this description and the quote or policy, the quote or policy will
prevail. Remember, this is just a quote form.
Please note that due to technical or natural events beyond our control,
like weather, we may not receive your quote. Please confirm that your
application has been received by calling to our toll free number
1-800-981-6545, Monday trough Friday from 8:30 am to 5:00 PM.
We
are going to process your application in our agency labor hour's: Monday
through Friday from 8:30 AM to 5:00 PM, except holydays.
It’s
our honor to serve you,
Nehemías
Toro Insurance Agent.
Fill in this information:
Required fields*
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Name*
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Residential Address*
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City and Zip Code of
Residential Address
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Postal Address
Same as Residential address?
Yes
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City and Zip Code of Postal
Address
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Phone Numbers (provide at least one of them)
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Residential Phone
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Area Code:
Number:
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Alternative Phone
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Area Code:
Number:
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E-Mail
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Structure's number of
Floors*
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Is the structure a Rented
One?*
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Yes
No
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Does the Structure has
Limited Access?*
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Yes
No
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Which Cover are you applying
for?*
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Property's Structure
Property's Content
Car
Umbrella (More
Information)
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What type of Construction
the Structure has?*
Optional if the Structure is a rented one
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Other:
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Structure Limit
What is the Structure's insurance amount you want?
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Content Limit
What is the Content's insurance amount you want?
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Public Liability (This cover is a must in any Personal Package)
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What is the Public
Liability Limit you want?
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Occurrence
What is the insurance amount per event?
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Aggregate
What is the total yearly insurance amount per event?
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Structure's Square Feet
Area*
If the structure's
construction type is a mixed one, please indicate percent of Concrete and
percent of wood/other
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Concrete:
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Wood/Other:
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Do you want to insure any
vehicle?
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Yes
No
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