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Ellett Insurance, P. L.

"Insurance Working for You"

 

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Ellett Insurance, P. L.
905 N.W. 56th Terrace., Suite A
Gainesville, FL 32605

Ed Ellett. CLU,CPCU,CIC
Phone: 352 331-8044
Fax: 352 331-2347

Hours
9 a.m. - 12 Noon
and

1 p.m. - 5 p.m.
Monday thru Friday
 

E-Mail: ellett@bellsouth.net


 

Miscellaneous Forms
 
Insurance coverage and change requests cannot be bound, altered, or changed by completing an application and faxing, mailing or e-mailing to Ellett Insurance, P. L. (Numbers denote each Acord form number)
 
A PDF reader is required to access these documents. Download Adobe Acrobat free.
 
  36 - Agent/Broker of Record Change
  11 - Auto Accident Information
  35 - Cancellation Request/Policy Release
  25 - Certificate of Liability Insurance
  24 - Certificate of Property Insurance
163 - Commercial Auto Driver Information Schedule
175 - Commercial Policy Change Request
  27 - Evidence of Property Insurance
  12 - Exchange of Information
  50 - Florida Auto Insurance Identification Card
  66 - Florida Credit Disclosure Information
175FL - Florida Workers Compensation Monthly Change Sheet
171 - Florida Workers Compensation Notice of Election
172 - Florida Workers Compensation Revocation of Election
  91 - Good Student/Driver Training
  92 - Medical Statement
  71 - Personal Auto Policy Change Request
  70 - Personal Policy Change Request (Except Auto)
  40 - Residential Property Valuation Survey
  73 - Solid Fuel Questionnaire
  37 - Statement of No Loss
139 - Statement of Values
  13 - Witness Information
  93 - Young Driver Questionnaire

Copyright (C) 2003 Ellett Insurance. All rights reserved.