NEXT DAY FLOOD APPLICATION
BUSINESS NAME
*
Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Address being insured
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Building Purpose
*
Please Select
Residential
Non-residential
Mix-use
Building Description
*
Example: Commercial, Apartment, detached garage...etc)
Building under construction?
*
Yes
No
Include Coverage for Additions or Extensions
*
Please Select
None
Building is Addition/Extensions
Excludes Additions/Extensions
Includes Additions/Extensions
Has the building been subtantially improved since the original date of construction?
*
List the year the building was improved.
Is the insured a condominium association?
*
Yes
No
Is the building a rental property?
*
Yes
No
Is the insured a tenant?
*
Yes
No
Is the insured a non-profit entity?
*
Yes
No
Is the policy force place by the lender?
*
Yes
No
Is the building located on leased Federal Property?
*
Yes
No
Is the insured a small business with less than 100 employees?
*
Yes
No
Did the applicant have a prior NFIP policy?
*
Yes
No
Number of detached structures
*
Number of Floors
*
Number of Units
*
Is there machinery and equipment elevated above the building's first floor?
Yes
No
Building Replacement Cost
*
Total Building Coverage
*
Total Contents Coverage
*
Submit
Should be Empty: