Flood Insurance Quote

Building and Contents
Building	Contents	Annual Premium
$20,000	$8,000	$202
$30,000	$12,000	$240
$50,000	$20,000	$302
$75,000	$30,000	$352
$100,000	$40,000	$385
$125,000	$50,000	$403
$150,000	$60,000	$425
$200,000	$80,000	$467
$250,000	$100,000	$499
$20,000	$8,000	$427
$30,000	$12,000	$465
$50,000	$20,000	$527
$75,000	$30,000	$577
$100,000	$40,000	$610
$125,000	$50,000	$628
$150,000	$60,000	$650
$200,000	$80,000	$692
$250,000	$100,000	$724

OR

Contents Only
Building	Contents	Annual Premium
0	$8,000	$321
0	$12,000	$351
0	$20,000	$395
0	$30,000	$419
0	$40,000	$439
0	$50,000	$460
0	$60,000	$481
0	$80,000	$505
0	$100,000	$530
0	$8,000	$96
0	$12,000	$126
0	$20,000	$170
0	$30,000	$194
0	$40,000	$214
0	$50,000	$235
0	$60,000	$256
0	$80,000	$280
0	$100,000	$305

These premiums are set by the National Flood Insurance Program and will not vary by Insurance Company. Click a premium to see if you qualify for any savings based on your home.

If your home’s total value is more than $250,000, and you would like additional coverage, please contact the agency listed in the 'Contact Us' panel.

I have read and agree to the Replacement Cost Information

Home foundation:

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Additions and Extensions Coverage:

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Additions and Extensions If you are unsure if your home has an addition or extension then answer 'Building does not have addition(s) or extension(s).

Do you have an attached garage:

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Number of floors:

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Is your home being built:

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Building Information “Being built” should only be selected if your home is being built and you have not yet moved into it.

What year was your home built:

How did you determine when
your home was built:

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Date you purchased your property:

Building Use:

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As part of the Homeowners Flood Insurance Affordability Act of 2014, a new surcharge was put in place by Congress on all National Flood Insurance Program (NFIP) policies. A $25 surcharge is applied to primary residences. A $250 surcharge is applied to all other properties.

You indicated this property is your primary residence. If this is incorrect, you can modify your primary residence selection.
ACTION ITEMS: To qualify for the lower $25 surcharge for a primary residence, you must complete this Verification of Primary Residence Status by checking the electronic signature box and clicking ‘Continue’ to complete your flood insurance application.
Please note, failure to complete this form will result in an additional $225 added to the premium due for this flood insurance policy.

The property address listed on this flood insurance application is my primary residence, and I and/or my spouse will live at this location for:

51% to 79% of the 365 days following the policy effective date.

80% or more of the 365 days following the policy effective date.

PURSUANT TO 28 U.S.C. § 1746 I DECLARE UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE UNITED STATES OF AMERICA THAT THE FOREGOING IS TRUE AND CORRECT.

07-26-2017

Insured Printed Name

Date

* By checking this box, I acknowledge my intent to submit this information for purposes of insurance. I understand I have an obligation to report any changes to the information above that occur during the 365 days following the policy effective date. Failure to report any changes in this information may result in voidance of the coverage.

Privacy Notice: The Flood Insurance Processing Center collects and uses personal information to process transactions. This information is not shared with outside parties except to the extent necessary to provide the service. We exercise appropriate data collection, storage and processing practices, and security measures to protect against unauthorized access, alteration, disclosure or destruction of your personal information.

* All the fields marked with an astericks (*) are required to complete this form for your flood insurance policy.

Premium

Quote Number:

Coverage will be effective:

08-25-2017 through 08-25-2018

Waiting Period Information A 30 day waiting period will apply to this policy.

Building Coverage:

Deductible Information This is the only available deductible option for this type of flood policy.

Contents Coverage:

Deductible Information This is the only available deductible option for this type of flood policy.

Yes, I’d like the protection and peace of mind that comes from having flood insurance.

Please note: The policy to which this premium applies is not subject to cancellation for reasons other than those set forth in the NFIP rules and regulations which you can read by clicking here.

Payment method:

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I have read and choose to purchase a Standard Flood Insurance Policy.

I have read and agree to the Terms and Conditions.

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Furnace	Heat Pump	Air Conditioner	Hot Water Heater
Oil Tank	Cistern	Washers / Dryers	Food Freezer

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Building and Contents

Contents Only

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Verification of Primary Residence Status for NFIP Policy Rating

Congratulations, here is the premium information for your home