Personal Auto Insurance in Palm coast, Bunnell & Flagler Beach, Florida

Personal Auto Insurance Quote

Flagler County Insurance Agency is an independent insurance agency with over 75 years of experience in a wide range of insurance products, including personal auto insurance. We serve the auto insurance needs of people in Flagler Beach, Bunnell, Palm Coast and the surrounding areas in Florida. If you need an auto insurance quote, you can request a quote on our website, call our office or come to the office.

We have built a solid reputation in Flagler County by tailoring our services to meet the needs of each client. We still do business the old fashioned way, by building relationships with our clients and offering personal service. Our staff of knowledgeable insurance professionals in our two locations is here to answer questions and offer guidance. Please contact us for auto insurance and all your insurance needs.

You can request an auto insurance quote on our website at your convenience. Complete the online form and we will respond with a quote for personal auto insurance. Please complete the form in its entirety, as the information is used to provide an accurate quote for auto insurance based on your driving record, vehicle types, age and other factors.

If you don't hear from us in a reasonable amount of time, please call our office for a fast quote. The form is a request for information only and doesn't bind coverage. That will only happen after you speak to an agent to bind coverage and are told your coverage is bound. If you prefer, stop by one of our locations in Bunnell or Palm Coast to discuss your insurance needs with one of our professional agents.

Please note that this form is for a REQUEST ONLY. By submitting this form it does not bind coverage in any way. If you do not hear from us in a reasonable amount of time, ASSUME WE DID NOT GET THIS REQUEST FOR AN INSURANCE QUOTE, and call our office.

I understand that filling out and submitting this form DOES NOT bind coverage in any way, and the only way coverage can be bound will be when I am informed of a binder or policy is issued by the agent representing me.

General Info
Name:
Address:
City:
State:
Zip Code:
Home Phone:
Cell Phone:
Email Address:
Best Time To Contact:
Contact By:

Current Policy Information
Agent:
Address:
City:
Policy Expiration Date:

Vehicle 1 Information
Year:
Make:
Model:
Number Of Doors:
Primary Driver:
VIN Number: (Optional, but will help us give you an accurate quote.)
Average Annual Mileage:
Airbags:
Automatic Seat Belts:
Anti-Lock Brakes:
Car Alarm:
Vehicle 1 Coverage Information
Comprehensive Deductible:
Collision Deductible:
Towing:
Rental Reimbursement:

Vehicle 2 Information
Year:
Make:
Model:
Number Of Doors:
Primary Driver:
VIN Number: (Optional, but will help us give you an accurate quote.)
Average Annual Mileage:
Airbags:
Automatic Seat Belts:
Anti-Lock Brakes:
Car Alarm:
Vehicle 2 Coverage Information
Comprehensive Deductible:
Collision Deductible:
Towing:
Rental Reimbursement:

Vehicle 3 Information
Year:
Make:
Model:
Number Of Doors:
Primary Driver:
VIN Number: (Optional, but will help us give you an accurate quote.)
Average Annual Mileage:
Airbags:
Automatic Seat Belts:
Anti-Lock Brakes:
Car Alarm:
Vehicle 3 Coverage Information
Comprehensive Deductible:
Collision Deductible:
Towing:
Rental Reimbursement:

Limit Liability for All Cars
Bodily Injury:
Property Damage:
Uninsured Motorist Limit for All Cars:
Stacked?:

Driver Information
	Driver 1	Driver 2	Driver 3
Name:
Occupation:
Length of Time At Job:
DOB:
Sex
Marital Status:
Smoke?:
Has Driver Completed Driver's Education?:
Is Driver A Student With "B" Avg or Higher?:

Driver Tickets and Accidents Please describe any traffic incidents for the drivers above that invovle tickets and/or accidents (i.e. Speeding, DUI, Accidents, etc).
Driver 1 Driver 2 Driver 3

Information About Driving Records If you answer yes to any of the following questions, please explain your answer in the "Additional Information" section below.
Has anyone in your household sustained any fire, theft or vandalism losses in the past 3 years?
Have you or a household member had a foreclosure, repossession, bankruptcy, judgment or lien in the past 5 years?
Do all drivers live in the state 10 months out of the year?

Additional Information In the box below, please provide any additional information you feel may be necessary for us to provide you with the best quote possible such as additional operators, coverages engines, etc.