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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 hours'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 Information
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Name*
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Physical Address of
Property*
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City and Zip Code of
Property*
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Postal Address
Same as Physical
Address? Yes
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City and Zip Code of Postal
Address
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E-Mail
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Phone Numbers (At least provide one)
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Main
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Area Code:
Number:
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Mobile
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Area Code:
Number:
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Fax
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Area Code:
Number:
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The purpose of this Quoting
is*
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Lending Institution Name
(ex: Citibank)
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Loan Amount
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Property's Actual Value*
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Do you know the flood
zone?*
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Yes
No
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If so, which one?
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Completed Construction
Date*
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Month:
Date: Year:
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Please Note: If you
Construction Date is higher than 1978, we need the Elevation Certificate
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Is the property under
construction right now?*(ex: Remodeling, Expanding)
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Yes No
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Cadastre's Number*
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Property's Occupation*
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Property's Number of Floor*
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Is the property an unit of
a Condominium?*
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Yes
No
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The property has a
basement?*
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Yes
No
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What is the Policy Amount?
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Property's Structure*
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Property's Content
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Deductibles
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Property's Structure*
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Property's Content
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