Request a Quote Form

For an insurance quote complete and submit the following information. This submission will result in your account executive contacting you to assist you with obtaining coverage.

* Indicates required fields. If you do not know the information please enter "NA" in the required field.

Contact Information
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Name of Entity to be Insured.
 
Federal Employer's Indentification Number.
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Quote Information
Please provide a quote on the following items: *








* if Other is selected.
Provide a brief explanation of the type of coverage that is requested.
* Indicates required fields. If you do not know the information please enter "NA" in the required field.
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Florida Municipal Insurance Trust (FMIT)   |    125 E. Colonial Drive, Orlando, Florida 32801
Post Office Box 530065, Orlando, Florida 32853
Phone: (407) 425-9142    |    Toll Free: 1-800-445-6248    |    Fax: (407) 425-9378

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