NJDF FAIR Plan Windows Rating Software
Order Form

NJIUA New Rates
Revised Rates/Rules Effective January 15, 2011 


Instructions
Fill Out and/or Verify Order Information and
Click on Continue Order for Credit Card Information

For check purchases, print form and mail with check made out to Electronic Insurance Office to
Electronic Insurance Office
32 Washington Street
Mt. Holly, NJ 08060

Agent Information
* Agency Name :
Address :
Address2 :
City :
State :
Zip :
* Phone :
Fax :
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* Email :
Checkout
NJ Dwelling Fire FAIR Plan Update eff:01/15/11
          
$79.95
3% Rating Bureau Royalty
          
$2.40
Total Amount
          
$82.35
     
Payments processed via the FirstData Secure Payment Gateway, Click for more information.       
 

No Sales Tax on Internet Delivery of Windows product
Additional Fees : Delivery of Windows CD $25.00
    (does not include royalty fee or sales tax) (Call (609) 267-1992 x109 for details)

Min System Req : 500MHz Intel Pentium/Celeron processor or equivalent / 64MB RAM / 75 MB of free hard disk SVGA color monitor compatible with Windows, minimum 800x600 screen resolution Windows 95 / 98 /NT 4.0 / ME/ 2000 / XP / Vista/ Win 7 operating systems running on Intel hardware.
Software capable of running on a stand-alone machine or under a network environment.