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    Your Current Coverage

    Your Current Insurance Company
    Please the type your current Insurance Company name. If not insured please type N/A.

    Your Current Policy Expiration Date
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    Please list all Licensed Drivers in Household & provide their License Numbers & Date of Birth (DOB)
    Separate each Driver with a comma, per the example below:
    Jane Doe (DOB: 10/02/1985) - License #:D000-000-00-000-0, John Doe (DOB: 02/06/1976) - License #:D111-111-11-111-1.

    Please list Make & Model for all vehicles in Household. If available, include VIN Number for most accurate quotes.
    Separate each Vehicle with a comma, per the example below:
    2007 Nissan Sentra - VIN#: JH4TB2H26CC000000, 2013 Honda Accord - VIN#: KL5UC3I37DD000000.

    I would also like additional information on:
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    Boat, Yacht & WatercraftCollectiblesCondo UnitsDwellingsFarms & RanchesFine Art

    Flood & Excess FloodHomeownersJewelryMobile HomesMotorcyclesMotor Homes & RVs

    Precious PossessionsRentersSelect Client ProtectionUmbrella & Excess LiabilityWindstorm

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    14821 South Dixie Highway, Miami, Florida 33176
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