Return to Home Page Miami Dade Insurance.com Home Page    | Welcome to the Website of Miami Dade Insurance.com!
Free Online Insurance Quotes from Miami Dade Insurance.com
Group Health Individual Health Life Insurance Mortgage Life Annuities Employee Benefits Estate Planning Long Term Care
 
Call Us Toll-Free NOW
To Get Your Phone Quote:

Or, Click Coverage
Below and We Will
RUSH a Quote to You!

click here for Service Request Form Service Request Form

Click Here to Email us Contact Us by Email

Click Here for our privacy notice Our Privacy Notice

Click here to learn more about our agency and services About Our Agency

 
Online Mortgage Life Insurance Quotation Request
One Simple Form - takes only 2-3 Minutes!

Your Personal Data:
 
Your Name:
Street Address:
City:
State: MUST be Florida!
Zip Code:
E-Mail (REQUIRED):
E-Mail again for accuracy:
Phone:
Fax (optional):
 
Marital Status:
Single Married
Homeowner?
Yes No
 
Currently Insured?
(If yes, list carrier, and # of years
continuous. If none, type N/C)
 
Unusual Activities?
(If you engage in unusual activities such as scuba diving, airplane flying, rock climbing, etc., list them here.)

Underwriting Information:
 
Name of Insured: Birthdate:
Sex (M/F): Smoker or
Non-Smoker?:
Height: Weight:
 
Amount of Coverage Desired? $
 
Current Mortgage Balance $
 
Number of Years Left on
Current Home Mortgage:
(i.e., 10 yrs., 15yrs., 30yrs., etc):
 
List Any Health Problems:
 
Reason for Buying Life Insurance:
 
Send my quotation via: E-Mail Fax
Regular Mail
Call Me by Phone

Thank you for filling out this form COMPLETELY!

We value your input as PRIVATE information. Every step has been taken to insure your privacy, security, and our intent is to release quote information only to you. We will not give your data to ANY other person or group for sales, marketing, or ANY other purposes. By checking the box below you agree to allow our agency to release this information via the method you have chosen, and to release us from any liability should this information be accidentally viewed by others. Our intention is to maintain your complete privacy.

Yes, I Agree. Please Send Me a
Life Insurance Quote NOW!

Click Button Below When Done

Please Click Only Once . . . May take up to 30 seconds!

 
Thank you for visiting the insurance web site of Miami Dade Insurance.com (Kendall Life & Health Insurance, Inc.)
E-Mail: lifeins@bellsouth.net   |   More About our Agency's Services    |    Privacy Notice/Copyright Info.
Kendall Life & Health Insurance, Inc   12973 SW 112th Street, Suite 304   Miami, FL 33186
Phone: 305-388-5590    |    Fax: 305-380-1816   |    © 2006 Insurance-Web-Sales
Questions/site-related problems, please E-mail us at: lifeins@bellsouth.net