An affiliate of Farmers & Merchants Bank
 
Tel: (850) 997-9981 Sam Rhody
Vice President and Managing Agent
 
 FAX: (850) 997-9978

 

Yes, I'm interested in the following products and services of FMB Insurance Services, Inc.

 

Personal Insurance

Auto Homeowners Life
Other (i.e., umbrella, boats, jewlry)

Business and Professional

Auto/Trucks Property/Liability
Workers Compensation Bonds
Professional Employer Organization Other

Financial Planning & Benefits

Estate/Tax Business Perpetuation Key Person
Retirement (401(k), et al) Health Benefits Other

Expiration of current insurance policies:

Personal

Automobile
Homeowners
Other

Business

Automobile
Property/Liability (i.e., business package)
Workers Compensation
Other

Name

Address



City, State, Zip + 4
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