Contact Information

We are located at:
5201 Blue Lagoon Dr.
Penthouse Suite,
Miami, FL 33126

Toll-free:
877-674-2366
Tel:
305-444-3692
Fax:
305-460-3692
Email:   MrInsurance@DozaIns.com

Homeowners, Condo & Rental Insurance

Contact Person*
Telephone*
Fax
Cell
Work Phone
E-Mail*
Insuring Location
County
Zip Code
Mailing Address (if different)
Swimming Pool
Screened/Enclosed
Garage/Carport
No. of Cars
Hurricane Shutters
If yes, inspection needed
Monitored Alarm
If yes, need certificate
Year Built
# of Baths Full
# of Baths 1/2
Square footage
No. of Stories
Roof work done after 1992
If yes, inspection needed
Roof Cover
Roof Type
Porch Open/Enclosed

If yes, Sq Ft.
Prior Insurance
Insurance Company
Expiration
Pets

If yes, breed
Flood
If yes, certificate needed
Additional Requests

       * Denotes required field