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Property Quote Sheet
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(850) 249-8060
Property Quote Sheet
Date
MM slash DD slash YYYY
Who took the quote?
*
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Cassidy
Jack
Will
Tori
Kelly
Kelley
Assigned Producer for NBL Sheet
Assigned Producer
WILL
JACK
Assigned Producer for AgencyZoom
Assigned Producer
Will Massey
Jack Taylor
Name
*
Nickname
What Kind of Quote
*
Select What Kind of Quote
Condo
Dwelling
Home
Renters
Source
*
Select Source
Bird Dog Referral
Client Referral
Cross Sell Client
Cross Sell Us
Friends/Family
Ins co Website
Internet Leads
Matrix X-Date
MMT Postcard
Neighborhood Mailer
Other Ins Agency
Past Client
Search Engine
Walk In
Bird Dog Referral
Client Referral
Phone
*
Email
*
What is Your Date of Birth?
MM slash DD slash YYYY
Occupancy
Select Occupancy
Primary
Secondary
STR
LTR Weekly
LTR Monthly
LTR Annual
Will this property be under your name or an LLC?
*
Will this property be under your name or an LLC?
My Name
An LLC
LLC Name
*
Property Address
Street Address
City
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District of Columbia
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Northern Mariana Islands
Ohio
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Tennessee
Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
If Secondary / Primary Address or Current Address?
Street Address
City
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
Office for NBL Sheet
*
Select Office
Brian Taylor Insurance
30A Insurance
Brian Taylor Insurance - PSJ
Office for AgencyZoom
*
Select Office
Brian Taylor Insurance
30A Insurance
Brian Taylor Insurance - PSJ
New Purchase
Closing Date
MM slash DD slash YYYY
Paid Cash / Purchase Amount
Loan Amount (Bank will require them to carry at least this amount of insurance)
Already Own Home / Condo - Currently Insured / Uninsured
Current Company
Renewal Date
MM slash DD slash YYYY
Dwelling Cov
Deductible
Premium
Not Currently Insured
How Long Without Insurance / Purchase Date?
Homeowners / Dwelling Fire
Year Built
If 2001 and older, do you have a wind mitigation report?
Year of Roof
Year water heater installed?
Smoke Detectors?
Smoke Detectors?
Yes
No
Alarm System?
Alarm System?
Yes
No
Do you own any other properties in Florida?
Pool?
Pool?
Yes
No
Diving Board / Slide?
Diving Board / Slide?
Yes
No
Screen Enclosure?
Screen Enclosure?
Yes
No
Yard Fenced?
Yard Fenced?
Yes
No
Dogs / Breed?
Trampoline?
Trampoline?
Yes
No
Condo
Name of Condo
What Floor Are You On?
Tags
Jack
Will
PCB
30A
PSJ
Homeowners
Dwelling Fire
Rental Condo
Non-Rental Condo
Flood
Auto
Boat
Bird Dog Referral
Client Referral
Cross Sell Client
Friends / Family
Ins Co Website
EverQuote
Matrix X-Date
MMT Postcard
Other Ins Agency
Past Client
Rewrite
Search Engine
Walk In
Gmail - PCB
Gmail - PSJ
Gmail - 30A
Margaritaville
New Purchase
Notes
***Get Zip Codes For All Addresses***
Phone
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