QUOTE REQUEST FORMS

Please select the type of quote you would like to receive information about:

Homeowners / Automobile Insurance Information Request

To discuss your Homeowners or Automobile insurance needs with one of our agents, simply complete your contact information below or call our office at 407-647-7901 or toll free
1-800-741-4831. We'll be happy to assist you.

Name:
Contact Method:
Home Phone:
Work Phone:
Email Address:
Mailing Address:
 
City, State, Zip ,

What coverages would you like to obtain information about?

Homeowners Insurance Automobile Insurance

Commercial Insurance Information Request

Please note that completion of the following request for information does not constitute the purchase of insurance. No coverage may be added, changed or bound as a result of submitting this request for information or quotation of insurance. All coverage must be confirmed by the agency in writing subject to an acceptable signed application meeting the underwriting guidelines of the Insurance Company.

Company Name:
Contact Name:
Contact Method:
Home Phone:
Company Phone:
Email Address:
Mailing Address:
 
City, State Zip ,

What coverages would you like to obtain information about?

Builders' Risk
Commercial Automobile
Foreign or International Coverages
Inland / Ocean Marine Floater		 Liability
Property
Workers' Compensation
Other

Tell us about your business

Employee Benefits Information Request

Please note that completion of the following request for information does not constitute the purchase of insurance. No coverage may be added, changed or bound as a result of submitting this request for information or quotation of insurance. All coverage must be confirmed by the agency in writing subject to an acceptable signed application meeting the underwriting guidelines of the Insurance Company.

Company Name:
Contact Name:
Contact Method:
Home Phone:
Company Phone:
Email Address:
Mailing Address:
 
City, State Zip ,

What coverages would you like to obtain information about?

Group Benefits

All types of health insurance, i.e., HMO, POS, EPO, PPO
Self Funded plans for Health & Dental, Incl. min. premium and ASO.
Dental - HMO, PPO & Indemnity
Life
Short & Long Term Disability
Voluntary Benefits, i.e., Life, STD, LTD, Dental, Vision, LTC, Accident, Cancer
Long Term Care
International Health Plans
Section 125/Flexible Savings Accounts/Medical Savings Accounts
Employee Pension & 401-K Plans
Employee Assistance Programs
Buy/Sell Funding Agreements
Key Executive Plans
Access to legislative updates/Human Resource Center
Compliance guidelines for COBRA, HIPAA, FMLA, Section 125
Customized employee communication materials

Individual Benefits

Life Insurance - All types available
Disability Income Insurance
Long-Term Care Coverage
Annuities
Health Insurance
Short Term Medical Plans
Foreign National Medical Plans

HELPING OUR COMMUNITY

CONTACT KRAFT INSURANCE

home - company - services - customer care - contact us - site map
Copyright 2007 Kraft Insurance - All Rights Reserved - Privacy Policy - User Agreement