Florida Day Care Insurance Quote Please enable JavaScript in your browser to complete this form. - Step 1 of 2Type of Child Care Facility Commercial DaycareIn-Home DaycareThe operation is located in: Location built specifically for a day care center or nurseryPrivate HomeChurchSchoolOtherDescribe location:Are other services in addition to day care and pre-school services provided?NoYesDescribe the other services:Has you licenses ever been suspended or revoked or are operating under a license "warning"?NoYesYear Licensed and License number Number of Children Licensed for?Average daily attendance?0 - 12 Months012345678910> 101 - 3 Years012345678910> 104 - 5 Years012345678910> 106 - 10 Years012345678910> 10Annual SalesActive OwnersFull Time EmployeesPart Time EmployeesAnnual PayrollDo you have children enrolled at your facility with special emotional or physical needs?NoYesDescribe condition(s), age of child(ren) and special care provided by staff:Play equipment on premises:SwingJungle GymSlideSandboxTrampolineInflatable bounce equipmentOtherDescribe other equipment:Is there a pool?NoYesIs pool fenced?NoYesAre there animals on premises?NoYesDescribe animals - if dogs list breed(s)Are there any special classes taught? (Swimming, Gymnastics for example?NoYesDescribe special classes:Are there overnight stays?NoYesDo you have a before or after school program?NoYesDo you or a third party provide transportation?NoYesIs valid commercial auto insurance in place?NoYesLimits of Liability Desired<$100,000$100,000$300,000$500,000$1,000,000$2,000,000>$2,000,000Will you like Sexual Molestation Coverage?NoYesSexual Molestation Limits<$100,000$100,000$300,000$500,000$1,000,000$2,000,000>$2,000,000Do you currently have insurance?NoYesExpirationInsurance Company NameHave you had any claims?NoYesProvide details of claim and amount paid by insurance companyIf you had losses we will require hard copy of losses from insurance company.NextCompany Name *Sole proprietor, corporation or LLC name Contact Name *Mailing Address *Address Line 1Address Line 2City--- Select state ---AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodePhysical Address (if different than mailing address)Address Line 1Address Line 2City--- Select state ---AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeEmail *Phone *Mobile PhoneTxt Msg ConsentYesNoBy select YES and entering your telephone number, you expressly authorize Dopazo & Associates, Inc. (“Dopazo”) to call or text you with offers and reminders at the number you provided, including through the use of the possible use of automated technology and recorded messages. You certify that the number you provided is your own number. If you change your number, you will notify Dopazo as soon as possible. You are not obligated to provide this authorization and it is not a condition to receive a quote or purchase or renew your insurance. You may revoke this authorization at any time by remove@dopazo.com. You understand and agree that standard text messaging rates will apply to any text messages sent to you by Dopazo and that Dopazo will not be responsible for any charges for text messaging.Federal Employer Number FEIN *Website / URLAcknowledgement *I AgreeI acknowledge and understand that insurance coverage cannot be bound or changed via submission of any online form/application provided on this site or otherwise. No binder, insurance policy, change, addition, and/or deletion to insurance coverage goes into effect unless and until confirmed in writing directly by a licensed agent.Submit