Woodbury & Co. - Flood Questionnaire

Flood Questionnaire
Elevation Certificate may be required

First Name
Last Name
Address
City
State
email

Elevated on:	Pilings Crawlspace Slab
# of Floors # of Families
Does area below elevated floor contain machinery or equipment? Yes No
Finished room? Yes No
Vented? Yes No
Breakaway walls? Yes No
Parking? Yes No
Storage? Yes No
Dwelling Coverage:
Contents Coverage:
Date Constructed:
Post-Firm Pre-Firm
Deductible: Building Contents
Flood Zone:

Bringing the World's Leading Insurers to the Carolinas Feel free to contact us at sales@woodburyinsurance.com
North Carolina		South Carolina
1111 Military Cutoff Road Suite 221 Wilmington, NC 28405 Ph. (910) 763-3431 Fax (910) 763-7637		4703 Oleander Drive Myrtle Beach, SC 29577 Ph. (843) 449-1414 Fax (843) 497-8541

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