LOOKING FOR COVERAGE?

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Request A Quote

Please complete the form below if you wish to obtain a quote from the Iowa Communities Assurance Pool (ICAP). A member of our team will be in touch within 24 hours of form submission.

Name of Public Entity

Person Completing this Form

First Name

Last Name

Your Position/Title

Contact Email Address

Phone

(###)

###

####

Do you prefer to be contacted via email or telephone?

Telephone

Proposed Effective Date

YYYY

Name and contact number for your local insurance agent, if applicable. If you do not have a specific agent you wish to work with, please list "None."

Does your entity currently have property and casualty coverage?

Yes

If yes to the above, please list your current coverage provider(s)