McCaleb Insurance Agency
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FILL OUT THE FOLLOWING AND SUBMIT FOR A FLOOD QUOTE
NAME:
ADDRESS:
ZIP:
STATE:
CITY:
EMAIL:
CONFIRM EMAIL:
CURRENTLY INSURED?
If yes, list carrier and # of years continuous.
HOME ADDRESS:
ZIP:
STATE:
CITY:
COUNTY:
FLOOD ZONE BEGINS WITH:
PHONE:
If flood insurance is required by a lender, 99% of the time the flood zone will begin with an "A".  If the structure is within one mile of the Atlantic or the Pacific Ocean or the Gulf of Mexico, it is possible the flood zone will be a "V".  Our underwriters will verify the flood zone you enter when we receive your quote submission and inform you if it is different than what you entered.  
IS THIS BUILDING A SINGLE FAMILY RESIDENCE?
IF YES, IS THE BUILDING OWNER OCCUPIED FOR AT LEAST 250 DAYS PER YEAR?
IS THE FOUNDATION OF THIS BUILDING A CONCRETE SLAB ON GRADE (NOT A BASEMENT, CRAWLSPACE, OR OTHER ENCLOSURE TYPE)?
AMOUNT OF BUILDING COVERAGE (IN $100 INCREMENTS)

MINIMUM $0 / MAXIMUM $500,000
$
AMOUNT OF CONTENTS COVERAGE (IN $100 INCREMENTS)

MINIMUM $0 / MAXIMUM $250,000 (1-4 UNIT BLDGS) $500,000 (ALL OTHERS)
$
DEDUCTIBLE:
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YesNo
AV
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