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$75.00 Quik Trip gas card.

When you refer someone to us for Homeowners, Landlords,
or Builders’ risk Insurance, we will send you a $75 gas card when we write the policy! 

Your Name: _______________ Client Name: ___________
Phone: ___________________ Phone: ________________
Email: ____________________ Cell: __________________
Address: __________________ Contract Amount: _______

staff@jeffdavidinsurance.com
jeffdavidinsurance.com