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SOL Insurance Agency
1370 W. Flagler Street
Miami, FL 33135
 
Toll Free: 888-476-5467
Phone: 305-643-2333
Fax: 305-541-0608

Insuring Florida
Residents & Businesses


Homeowners Insurance
Quotation Form
One Simple Form - takes only 2-3 Minutes!


Your Personal Data:
 
Your Name:
Property Address:
City:
Your "County" is?
State: (Must be Florida)
Zip/Postal:
E-Mail (REQUIRED):
E-Mail again for accuracy:
Phone:
Fax (optional):
 
Primary Policyholder's Birthdate:
(REQUIRED - Some companies products
offer discounts for certain age groups.)
 
 
Dwelling Information
 
Year Home Built:
Home Square footage:
 
Is your home occupied by: You Tenant
Is your home in a flood zone? NO YES
 
If so,
Do you have an
Elevation certificate?
NO YES
 
Number of units: Single family home
Duplex
 
Type foundation: Basement
Slab
Crawlspace over slab
Other (list in remarks)
(If basement, what % is finished?)
% FINISHED
 
Type Construction: Wood Frame
Brick/Masonry
Stone
Other (list in remarks)
 
Type Roof: Shingle
Wood Shake
Tar/Gravel
Spanish Tile
Metal Other
 
Number of stories: One 1.5
Two Three
 
Do you own animals or pets? Yes No
If yes, list type/for dogs, list breed:
 
Do you have a pool? Yes No
 
# of feet to nearest
fire hydrant:
# of miles to nearest
fire station:
 
Does Home Have a Garage? Yes No
Tell whether built in, detached/attached, and how many cars?
 
Currently Insured? Yes No
Name of Carrier & how long insured?
 
Prior Claims? Yes No
Describe claims in detail:
 
Rate Your Credit History and Past Insurance Payment History:
(Some companies products are
based on your credit and payment history.)
Excellent Fair
Poor Horrible
 
Plumbing type: Copper Galvanized
Mixed (Copper/Galvanized)
 
 
Heating Type: Gas (Propane or natural)
Electric
Oil (if oil, list tank location in remarks)
 
Circuit Breakers or fuses? Breakers Fuses

# Bedrooms: # Bathrooms:
 
# Fireplaces: # Chimneys:
 
Special features
(i.e., deck, air conditioning, alarm systems, pool, etc.)
 
Coverages:
 
Dwelling Cov. $ Contents $
Liability Cov. $ Deductible $
($250, $500, $1,000, etc.)
 
Comments/Remarks
(describe any scheduled jewelry, in-home business, oil tank location, or other special coverages/remarks here):
 
"Money Saving" Reports:
The following reports can save you up to 42% in your Homeowners insurance policy. Please indicate if these reports are available.
Florida Wind Mitigation Report? Yes No
 
Florida property appraisal Report? Yes No
 
Current Alarm Certificate Yes No
 
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