I affirm that I have express instruction and authorization for Steadily Insurance Agency, Inc. to use personal information, including review and generation of an insurance report, for the purposes of obtaining an estimate of the cost of insurance. I will either provide this to Steadily or maintain record of it for 5 years. I affirm that the resulting estimate will not be used as a quote or offer of insurance and only a licensed insurance agent may: 

• Discuss specific insurance policy terms or coverage
• Recommend insurance products
• Quote insurance products
• Sell, solicit, negotiate or bind insurance