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Homeowners Insurance
Let us provide a quote for you

 

We have several companies to choose from to provide the most suitable coverage at the best possible rate.

Once we receive your information, we will determine the replacement cost value of your house. If possible, we will have our inspector contact you in order to come out to get an exterior picture of your house and exterior dimension.

We will quote the best homeowners program we have based on your needs. Ideally, we would quote the coverage on the house at 100% of replacement cost. We ask a lot of questions. The answers are all important and let us do the best possible job for you.

 
     
Please complete the following form:  
Name
 
  Street Address
 
  City
State
Postal Code
   
  Phone Number
 (Daytime)
Phone Number
 (Evening)
     
Email Address
 
  Social Security Number:
Date of Birth:
     
Occupation:
 
Location of house if different than above  
   
Current Coverage:  
   
  Current Insurance Company Name:
 
  Expiration date of coverage Date:
 
  Current cost of insurance per year Amount:
   
  Age of house/year built: Year:
   
  Date purchased: Date:
Purchase price:
   
Number of Families: Number:
Number of stories:
Occupancy:
 
  Construction Type: Type:
   
  Garage: Select:
Type
Number of Cars:
 
  Electrical Select:
Renovations to Electric:
 
Roof type: :Type:
Date Replaced:
  Heating System: Renovations to Heating System:
Supplemental Heating Units:
 
  Plumbing Type: Type:
Renovations to Plumbing System:
   
 
To establish replacement value, we would like to get a listing or the rooms by floor:
 
           
  Porch:      
  Deck:      
  Full Basement: Finished Off:  
  Wood Stove: Professionally Installed:  
  Fireplace:      
  Attic: Finished Off:  
Smoke Alarms:
  Fire Extinguishers:      
  Security Alarms: 24-hr central station:  
Dead Bolt Locks:
  Do You Smoke:      
  Own Pets: What breed:  
Swimming Pool: Pool Type:
  Own Other Property:      
Recreational Vehicles:
  Business Exposure (Ex. Office Studio):      
  Provide Day Care in Home:      
Trampoline or any other outdoor recreational equipment:
  Interested in homeowners, condominium or renters coverage:      
           
  Collectables such as Jewelry, Furs, Guns (Please List):  
           
Square footage of the home:
Desired amount of coverage:
  Describe the losses in the last 3 years:      
   
     


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