Crystal Beach Insurance Agency, L.L.C.

Opening Soon! Crystal Beach Insurance #2

1366 Hwy 87, Suite D, Crystal Beach, TX 77650

1293 Hwy 87, Gilchrist, TX 77617

  
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Thank you for filling out the form below. All information is kept CONFIDENTIAL, and used for quoting purposes only.
The field marked with (*) are required fields.
* PLEASE GIVE US THE FULL NAME OR NAMES TO BE LISTED ON THE POLICY.
* WHAT IS THE COMPLETE ADDRESS TO BE INSURED?
* WHAT IS YOUR MAILING ADDRESS?
* PLEASE GIVE US YOUR CONTACT NUMBERS.
* MAY WE HAVE YOUR EMAIL ADDRESS?
* HAVE YOU FILED FOR BANKRUPTCY IN THE PAST 7 YEARS?
* PLEASE TELL US THE PRIMARY USE OF THIS HOME. WILL IT BE A PRIMARY HOME, VACATION/SEASONAL, OR A RENTAL HOME?
* PLEASE LIST the YEAR that any UPGRADES, REPAIRS, OR REPLACEMENTS YOU KNOW OF TO THE ELECTRICAL, PLUMBING, ROOF, ETC.
* Do you know the "ACTUAL" YEAR the home was built? (The GALVESTON C.A.D. may show an EFFECTIVE YEAR.) THIS INFORMATION MAY HELP WITH GRANDFATHERING IF YOU KNOW THE ACTUAL.
* WHAT IS THE $$ AMOUNT OF FIRE/HOMEOWNERS COVERAGE DESIRED? (Should be at least 80% of replacement cost min.)
WHAT DOLLAR AMOUNT WOULD YOU LIKE FOR CONTENTS COVERAGE ON HOMEOWNERS/FIRE? (HOUSEHOLD ITEMS)
* WHAT IS THE DESIRED $$ AMOUNT OF WINDSTORM COVERAGE DESIRED? (T.W.I.A. REQUIRES a min. of 80% of replacement the cost.)
* WHAT DOLLAR AMOUNT WOULD YOU LIKE FOR CONTENTS COVERAGE ON WINDSTORM? (HOUSEHOLD ITEMS)
* WHAT IS THE $$ AMOUNT OF FLOOD COVERAGE DESIRED? We suggest 80% of replacement cost. But, not required. (An ELEVATION CERTIFICATE is required for Flood quotes on dwellings built after 1974.)
WHAT DOLLAR AMOUNT WOULD YOU LIKE FOR CONTENTS COVERAGE ON FLOOD? (HOUSEHOLD ITEMS)
* IS THERE AN ENCLOSURE BELOW YOUR HOME? IF SO, IS IT MORE OR LESS THAN 299 SQUARE FEET? DOES IT HAVE BREAKAWAY WALLS OR FLOW THRU VENTS?
WE KNOW THIS IS DIFFERENT THAN POLICIES ON THE MAINLAND, SO PLEASE FEEL FREE TO ADD ANY COMMENTS, OR ASK ANY QUESTIONS YOU MAY HAVE.
If this home is a new purchase, please give us the name of the LISTING Real Estate Agency to help us gather additional information on the home.
WINDSTORM:
Possible Forms Required depending on repairs done, and "actual" year built, (to write policy, not to quote) may be a WPI-8, Pool-BC 1085, and/or a copy of the previous owners or your past Windstorm Policy # or Dec. page. ACTUAL year built really helps!

HOMEOWNERS/FIRE:
It always helps to know the ACTUAL year built, & any Upgrades, Improvements, or Replacements to the Roof, Plumbing, Electrical, Water Heater, A/C Heating System, etc.

FLOOD:
Knowing the ACTUAL construction date of your home could possibly help in lowering your premium by GRANDFATHERING, or insuring your home as pre-firm. Usually the "EFFECTIVE YEAR" is listed on the Galveston CAD, not the ACTUAL year.
ALSO, if your home was built AFTER 1974, an ELEVATION CERTIFICATE IS REQUIRED to quote.
Please fax, mail, or drop it off.