|
The disability insurance leads program designed for south Florida
Independent Insurance Agents and Captive Insurance Agents
|
|
The City Insurance Agents Lead Buying Advantage
|
|
Florida Disability Insurance
Lead Information Example
|
|
Copyright 2006 - 2011 OasisEarth Internet Group - All rights reserved
|
|
CityInsuranceAgents.com - 3324 W. University Ave. # 285 - Gainesville, Florida 32607
|
|
CityInsuranceAgents.com shall not be responsible or liable for any products, services, information or other materials displayed,
purchased, or obtained as a result of any information or offer in or results of any kind obtained in connection with this website, including, without limitation to any agent referrals, recommendations, application, approval, prequalification, or analysis. Nothing on this website contains an offer, promise or otherwise, either to make a specific insurance policy or that any participating insurance agent, insurance agency, or advertiser will make any insurance policy for any purpose or on any specific terms. CityInsuranceAgents.com is not an insurance agency. |
|
Website Builder & Managed by InsuranceWebsiteServices.com
|
|
Applicant_First_Name: Bob
Applicant_Middle_Initial: W
Applicant_Last_Name: Smith
Applicant_Mailing_Address: 555 NW 45th Street
City: Fort Lauderdale
Zip_Code: 33310
Applicant_Email_Address: bobs@yahoo55.com
Applicant_Home_Phone: 305-555-5555
Applicant_Work_Phone: 305-555-4444
Extension_Number: 55
Contact_Me: Phone at Home
Applicant_Cell_Phone: 305-555-7777
|
|
Applicant_Gender: Male
Applicant_Height_In_Feet: 6
Applicant_Weight: 200
Smoker: No
Currently_Insured?: Yes
|
|
Contact Information
|
|
Coverage Information
|
|
Current_Mthly_Premium: $75
Occupation_or_Title: accountant
Monthly_Gross_Income: $7,000
Explain_Job_Duties: accountant
Government_Employee?: No
Business_Owner?: Yes
Want_Short_or_Long_Term_Disability?: Short Term
Disability_Coverage_For?: Myself Only
Type_of_Disability_Coverage_Needed?: Accident &
Health
Monthly_Benefit_Amount_Desired$: 2,000
Benefit_Period: 1 year
Elimination_Period: 60 days
Payment_Mode: Quarterly
|
|
No Contracts!
No Start Up Fee!
|
|
CITY INSURANCE AGENTS
|
|
The City Insurance Agents Lead Buying Advantage
|
|
South Florida Insurance Agents
|
|
Fort Lauderdale - Coral Springs - Sunrise - Weston - Lauderdale Lakes - Miami - Hollywood - Miramar
|
|
Pompano Beach - Boca Raton - Tamarac - Davie - Sunrise - North Lauderdale - Deerfield Beach & more
|