Press Here for an Auto Quote Instead Let’s work together on a Homeowners or Condo Quote Name * First Name Last Name Date of Birth * Please list your Date of Birth Second Named Insured (If Applicable) First & Last Name of your spouse or significant other. If none skip to the next question. First Name Last Name Second Name Insured Date of Birth (If Applicable) Please list the Date of Birth of spouse or significant other. If none skip to the next question. How will the property be deeded? * Individual Name Trust LLC Corporation Irrevocable Trust Land Trust Telephone * (###) ### #### Consent to Receive Text Messages about Policy Information or Quotes (Optional) By checking this box, I consent to receive SMS messages from Bogey Insurance, LLC related to your insurance needs at the phone number provided above. The SMS frequency may vary. Data rates may apply. For assistance reply HELP. Reply STOP to opt out of receiving text messages. Please review our Privacy Policy and Terms & Conditions (Linked at the Bottom of the Page) Agree Email * Your email so we can send a copy of your insurance estimate. Contact Preference Phone (Fastest Response) Email (Some Emails may be filtered in your Spam Folder) Both Home Address for Insured property location * How much is your home insured for now? / If new purchase, what is the purchase price? Deductibles Desired $1,000 All other Peril, 2% Hurricane $2,500 All other Peril, 2% Hurricane $5,000 All other Peril, 2% Hurricane I qualify for the following discounts Centrally Monitored Alarm Local Alarm Retired Gated Community How is the home occupied? Primary Secondary Rented to others Annually Rented to others Seasonally Short Term Rental (Less than a Month) Occupied by friends or family How many months per year is your home occupied? 9-12 6-8 4-6 1-3 Do you have a car registerd in Florida? Or Do you plan to register a car in Florida? Yes No You may be able to save up to 20% off your home and auto insurance by bundling. If you would like to learn more please provide the Year, Make, and Model of your Florida cars. Example (2015 Kia Sorento) Do you have a mortgage on the property? Yes No The walls on the home are constructed mostly of the following material: Concrete Block / Masonry Wood Frame Poured Concrete Roof Type Shingle Tile Metal Flat Concrete Roof Other The Age of Roof? Liability & Medical Payments $300,000, $5,000 $500,000, $5,000 $100,000, $1,000 Other Option Do you have any pets? If Yes please answer below: None Yes If you have a pet please list the breed and if the pet has bite history Please verify one of the following: New Purchase or Currently Insured I received a Non-renewal on my Insurance My Insurance Expired less than 30 days ago My Insurance Expired over 30 days ago Please indicate the name and expiration date of your insurance company: Any prior claims in the last five years? Please briefly describe the type of claim and estimate the date. How Did you find us? Received Mailing/Looked up on Internet/Current customer/Someone referred you to us! What kind of water piping does your home have? PVC/Copper PEX Polybutylene Galvanized Pipes Unsure Would you like a flood quote with your home insurance? Yes No Have you lived at the property address to be quoted for MORE than 2 years? Yes No If you have lived at the property to be quoted for LESS than two years please provide your last or prior address? Preferred Mailing Address (if not the Insured Address) Thank you for Submitting your Request for a Home Insurance Estimate. Our dedicated staff team will reach out to you as soon as we have prepared an estimate for your property or if we require any more information. If you would like to talk to someone right away, feel free to give us a call at 239-790-4447! Required InformationIf you are not sure on how to answer one or multiple of the questions feel free to skip it or enter not sure. Also feel free to give us a call at 239-790-4447! Additional Information(Not Required)We recommend filling in as much information as possible as this will provide you with the most accurate estimate! Scroll down to the bottom to submit!
