Flood Risk Evaluation
This form will help identify aspects of your property/insurance coverages that we can discuss as they relate to protecting you from flood damage.
What is your full name?
What is your first name?
What is your last name?
What is your preferred phone number?
What is your email address?
What is the address of the property you would like to discuss Flood insurance for?
Do you have a flood policy in place today?
Do you have an excess flood policy in place today? (Excess flood insurance provides additional coverage limits above those provided by a primary flood policy.)
Do you have an elevation certificate for your property?
Please upload your elevation certificate so we can review it.
Please select the risk mitigation strategies you have at this property to help prevent flood damage.
What other risk mitigation strategies do you have a this property to help prevent flood damage?
Have you done any renovations or are you planning any renovations?
Please tell us about the renovations.
What is the occupancy of the home we are discussing flood coverage for?
Is this property owned by a trust, LLC or other entity?
Please tell us the legal name of the trust, LLC or other entity that owns this property.
Did you pay off a mortgage recently?
Are there any outbuildings (fence, detached garage, shed) you would like to discuss flood coverage for?
Please tell us about the outbuildings you have at this location?
Does this property have a finished basement?
Do you have art, jewelry or antiques that you would like to obtain flood coverage for?
Please describe the valuable articles you would like to obtain flood coverage for.
Is there anything else you would like to discuss regarding flood insurance with us?
Disclaimer: This online questionnaire is a tool used to gather information. It is not an application for insurance. No insurance coverage will be bound or put into effect by submitting this form.
Consumer disclosure: By checking the box below you authorize the Agency who supplied this form to you to contact you via phone, email, and text messaging; to save and share with business partners the information you provided; to obtain consumer reports that may include credit-based reports (where legally allowed), public records, claims history, and driving records so that they can give you accurate insurance quotes.