Flood

  • Applicant
  • Home
  • Property
  • Carrier
  • Coverage
  • Select Agents
  • Finish

Applicant

Can you tell us about yourself?

First Name *
Last Name *
Birthdate *
Marital Status
The name of the ownership or (title) of the property *

Where should we send your quote?

Email *
Phone *

Please fill all the mandatory questions.

Home

Home Address

Address *
City *
State *
Zip Code *

Mailing Address

Address *
City *
State *
Zip Code *

Please fill all the mandatory questions.

Property

Construction of the Home

Home Structure *
Home Structure Specify *

Protection

Do you have any Home Security?
Do you have any protection for Fire?
Do you have any protection for Smoke?
Do you have any protection for Burglar?

History

Year Wiring/​Electrical was Renovated *
Year Plumbing was Renovated *
Year Heating was Renovated *
Year Roofing was Renovated *
Year Exterior Paint was Renovated *

Please fill all the mandatory questions.

Carrier

Date of closing the Escrow
Please explain the reason not carrying an insurance

Please tell us about your current insurance

Prior Insurance
Home Insurance
Prior Home Insurance Carrier *
Enter Other Home Carrier Name *
Prior Home Insurance Expiration Date *
Auto Insurance
Prior Auto Insurance Carrier *
Enter Other Auto Carrier Name *
Prior Auto Insurance Expiration Date *

Losses / Claims 1

Loss / Claim details
Type of loss *
Date of loss
Amount of Loss
Description of loss

Please fill all the mandatory questions.

Coverage

What are your coverage limits?

Current dwelling limit *

Additionals

Please fill all the mandatory questions.

Select Agent(s) to Get Quote From:

Agent Info
Representing Companies
Barry M Kamran
Agency's Agent Rep
  • Barry M Kamran
  • 2072 Orchard Dr Newport Beach, Newport Beach, California, 92660
  • View Profile
  • Prudential
  • National General Insurance (GMAC)
  • National Life
  • Nationwide Mutual Insurance Company
  • Next Century Insurance
  • Ohio Mutual Insurance Company
  • Pacific Life
  • Philadelphia Insurance Companies
  • Principal Financial Group
  • Progressive
  • Modern Woodmen of America
  • RLI Corp.
  • Safeco
  • State Auto Insurance Company
  • The Hartford
  • The Philadelphia Contributionship
  • The Travelers Companies
  • Topa Insurance Company
  • Unified Life Insurance Company
  • Zurich Insurance Group
  • Hiscox Small Business Insurance Hiscox Insurance Company
  • Applied Underwriters
  • Assurant
  • Bankers Insurance Group
  • Berkshire Hathaway - GUARD
  • Chubb Corp
  • Cigna Health Spring
  • CNA Insurance
  • Colonial Life, Accident Insurance Company
  • Hanover Insurance
  • American Bankers Association
  • Infinity Insurance Company
  • Kaiser
  • Kemper Corporation
  • Liberty Mutual
  • MAPFRE U.S.A. Corp.
  • Markel Corporation
  • MassMutual
  • Mercury Insurance
  • MetLife
Jen K
Enhanced Plus Agents
  • Jen K
  • San Antonio Avenue Golden Rectangle, Carmel-by-the-Sea, California, 93921
  • View Profile
  • Aflac
  • Allied Insurance Company
  • American Automobile Association (AAA)


Thank you!

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