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Special Basic Package*
Choose Appliance Package
Realty Special Gold Package - $449.00
Bassett Premier Realty Inc Gold Package- $449.00
Century 21 Gold Package - $449.00
Coldwell Banker Gold Package - $449.00
ERA Realty Gold Package - $449.00
Florida Fine Homes Realty - $449.00
Fox Fire Realty Gold Package - $449.00
Keller Williams Realty - $449.00
Morris Realty & Investments Gold Package- $449.00
Properties of the Villages Gold Package- $449.00
Realty Executives - Gold Package- $449.00
Re/Max - Gold Package- $449.00
Sellstate Realty - Gold Package $449.00
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Additional Options Available
Pre-Season Check up
Plumbing and Electrical Repair Only
Printed Circuit Boards
Second Air Conditioner
Second Refrigerator - SILVER ONLY
Sub-Total:
Tax (7.00%):
Grand Total:
Property To Be Covered
Seller`s Name*
Seller`s Email
Address 1*
Suite or Apt #
City*
State*
Choose a State
Arizona
Florida
Nevada
Texas
Zip Code*
Seller`s Phone Number
Age of Home
Salesperson Name
Buyer Information
Buyer`s Name
Buyer`s Phone Number
Buyer`s email
Buyer`s Address
Buyer`s City
Buyer State
Buyer`s Zip
Agent`s Information
Agent`s Name
Agent`s Phone
Agent`s Email
Real Estate Company
Address
Address 2
Closing Company
Closing Company Name
Escrow Officer
Phone Number
Email
Closing Date
Payment Information
Payment Method*
Choose a Payment Method
I want to Mail a Check
I want to pay by Credit Card
Please make mail your check to:
Broward Factory Service
15980 S. US Highway 441
Summerfield, FL 34491
Card Brand*
Choose a Card
American Express
Master Card
Visa
Credit Card #
Expiration Date
CVV#
Billing Same as Covered Property Address?
Yes
No
Billing Address
Address Line 2
Billing City
Billing State
Choose a Billing State
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Billing Zip
Confirmations - Email confirmations will be sent from Connley Davidson.
Confirmation #
BFS SalesPerson Email*
cdavidson@browardfactory.com
Please click here for Terms and Conditions
The rate charged for the service agreement is not subject to regulation by the Office of Insurance Regulation.
Florida - A/C CA-C056778 Florida - A/C CA-C057400 Florida- Plumbing CFC1430745
Florida -Electrical ES-0000336 - Florida Electrical EC13007734
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