Full Name:          
Mailing Address:
City:
Florida
Zip Code:
Daytime Phone:     Ext.
Evening Phone: 
Cell Phone:           Fax:
(Email Address Required)
Flood Zone:
County:       

Building Occupancy:

Are you applying for this flood insurance policy on behalf of
the lender for the Mortgage Portfolio Protection Program?    

Condo Association and Residential Building?                        

Has property incurred 2 or more losses?                              

Is property granfathered into a B, C, or X Zone?                  

Select Policy Type:

Florida Flood Coverage Information:

Replacement Cost:           $
Total Building Coverage:  $
Total Contents Coverage: $

Building Type:       
Construction Date:  (mm/dd/yyyy)
Number of units in building:
Condominium Association:

Basement / Enclosure or Crawl Space:

Basement / Enclosure of Crawl Space:
Does enclosure or crawl space area have compliant venting:
Finished Area:
Machinery / Equipment:
Building Elevated:         
Lowest floor which includes living
area, is off the ground by means of:
Area used for:   
Square foot area:
Enclosure Walls:

Contents Location:

Miscellaneous Information:
Is building flood proofed:
Wave height adjustment:

Florida Flood Insurance Question:


Click on the "Submit Information" button below to send
your Florida Flood Insurance quote request.**


**Information received from this Florida Flood Insurance quote request
form sent to Landmark Insurance Agency will be for our use only and will
not be sold, given to or distributed to any other parties. A quote will be
based on the flood insurance policy information provided and does not
guarantee acceptance of the risk by us. The precise coverage afforded
is subject to meeting underwriting guidelines, and the terms, conditions
and exclusions of the policy as issued. By submitting this request you
acknowledge that this is neither an offer to insure nor a guarantee of
insurance. Completion of this form does not entitle you to a Florida Flood
Insurance policy. We are licensed in Florida and will not provide quotes
for other states.


Florida Flood
Insurance Quote
We can provide affordable Florida Flood Insurance
coverage's in south Florida and throughout Florida!
Landmark Insurance
Agency of Delray
Beach, FL offers
affordable and
experienced personal
insurance coverage
services throughout
Florida.
Contact us about
Florida Auto, Renters,
Homeowners, Condo,
Motorcycle, Boat, and
Flood Insurance at
(561) 496-2408.

In addition to a Florida
Flood Insurance quote,
we also offer affordable
Homeowners Insurance
policy quotes.
We are a Delray Beach, FL based insurance agency offering low cost
Florida flood insurance policy quotes in the following cities and counties:
Boynton Beach, Gulf Stream, Boca Raton, Lantana, Rainbow Lakes,
Atlantis, Lake Worth, South Palm Beach, Palm Springs, Greenacres,
Wellington, Haverhill, Palm Beach, Golden Lakes, Riviera Beach, Glen
Ridge, West Palm Beach, Lake Park, Royal Palm Beach, Jupiter, Coral
Springs, Fort Lauderdale, Parkland, Coconut Creek, Margate, North
Lauderdale, Lighthouse Point, Hillsboro Beach, Deerfield Beach, The
Hamptons, Highland Beach, Weston, Plantation, Playland Isles, Melrose
Park, Lauderhill, Sunrise, Tamarac, Wilton Manors, Oakland Park,
Lauderdale Lakes, Sea Ranch Lakes, Villages of Oriole, Pompano Beach,
Lauderdale-by-the-Sea, Boca West, Boca Pointe, Juno Beach, North Palm
Beach, Loxahatchee, Belle Glade, Palm Beach Shores, South Miami,
Cutler Ridge, Princeton, Perrine, Naranja, Homestead, Florida City, Leisure
City, Richmond Heights, Pinecrest, Howard, Coral Way Village,
Westchester, Westwood Lakes, Brownsville, Sweetwater, Key Biscayne,
North Bay Village, Miami Beach, Miami Springs, Virginia Gardens, Hialeah,
El Portal, Miami Shores, Medley, Indian Creek, Surfside, Bal Harbour,
North Miami, Biscayne Park, Pinewood Park, Opa Locka, Bunche Park,
Hialeah Gardens, Palm Springs North, Carol City, Norland, Ojus, Miami
Lakes, Biscayne Gardens, Hallandale, Sunny Isles Beach, Golden Beach,
Aventura, Uleta, Miramar, Pembroke Pines, North Miami Beach, Hallandale
Beach, Ives Estates, Pembroke Park, Coral Gables, Kendall, Dania Beach,
Cooper City, Davie, West Miami, Hollywood, Broward County, Martin
County, Palm Beach County, and Miami-Dade County, FL. We can also
offer Florida flood insurance coverage quotes throughout the Sunshine
state, including in Miami, Orlando, Tampa, St. Petersburg, Tallahassee,
and Jacksonville, FL.

Applicant Information:
Landmark Insurance Agency
4975 W. Atlantic Avenue
Delray Beach, FL 33445
Palm Beach County, Florida
(561) 496-2408
Fax: (561) 496-7740

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