Robinson Insurance, Inc.

Homeowner's Quote

Applicant
Name *
Date of Birth
Current Street Address *
City *
State *
Zip Code *
Email *
Phone Number
Property Location
Enter only if different from mailing address.
Address
City
State
Zip
County
New Purchase
Enter only if property is a new purchase for you.
Closing Date
Purchase Price
Previous Mailing Address
Current Insurance Information
Do you have prior coverage? Yes  No
Company Name
Current Annual Premium
Expiration Date
Non-Hurricane Deductible Desired
Hurricane Deductible Desired
Amount of Liability
Exclude Wind Coverage? Yes  No
Is the home currently for sale? Yes  No
Dwelling Information
Occupancy
Usage
Dwelling Type
Number of Bedrooms
Number of Bathrooms
Square Footage
Year Built
Year of Roof
Central Air & Heat Yes  No
How Many Floors? 1 Story
1.5 Story
2 Story
Bi-Level
Tri-Level
Other
Type of Construction Wood Frame
Masonry
Brick Veneer
Other
Other Features Dead Bolts
Smoke Detectors
Fire Extinguisher
Central Station Fire Alarm
Central Station Burglar Alarm
Home Located within 5 miles of Fire Station
Home Located within 1000 feet of a Fire Hydrant
Home located within City Limits
Swimming Pool
Swimming Pool Enclosure
Spa
Diving board or Slide
Trampoline or Skateboard ramp
General
General Underwriting Questions
Do you own any pets / animals? If so, disclose breeds and whether or not there is bite history.
Have you filed for bankruptcy within the past 5 years?
Is there a business on premises?
Do you own other homes? (Locations & Occupancies)
Claims
List any claims in past 5 years:
  Date Amount Paid Claim Type Description
1.
2.
3.
* = Required Field
Disclaimer Notice - The premiums quoted are estimates based on information you provided. This quotation does not constitute a contract of insurance, nor does it provide coverage for any loss or claim. Coverage can only be bound by an agent with a signed application and a down payment.

Protect What Matters Most

Robinson Insurance was established on Fifth Ave in Indialantic by the Robinson family back in 1959. Family owned and operated for over 55 years, our office of experienced agents understands the challenges faced by Melbourne insurance consumers. It is essential to have an agent in your corner that takes the time to properly analyze the various options open to you -- both insurance and non-insurance options -- and suggest the best alternatives for you, your family, and your company. Only then are you in a position to make a knowledge-based decision. 
There's a reason Robinson Insurance has been in business 55+ years.
Call us today!


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RobinsonIns@cfl.rr.com

(321) 723-1278

Monday - Friday, 8am - 4pm
Appointments Recommended







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