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Great! What type of insurance are you looking for?

Approximately what year was the property built?

What type of property is it?

What type of construction is the property?

What type of roof?

How many stories?

How many bedrooms?

How many bathrooms?

What type of garage?

What type of foundation?

Approximately how many square feet?

What is the primary heating system?

Are there any potential discounts?(check any that apply)

What type of fire alarm?

What type security system?

What is the municipal location?

Are there any add-ons or improvements?(check any that apply)

Are there any past claims?(check any that apply)

What kind of liability protection are you looking for?

What kind of deductible are your looking for?

Home address:

City:

What is your full name?

What is your email address?

What is your phone number?

Approximately how many square feet?*

Any10k+
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Are there any potential discounts?*(check any that apply)

None
Deadbolts
Smoke Alarms
Fire Extinguishers
Nearby Fire Hydrant
Manned Fire Station within 5 Miles
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Are there any add-ons or improvements?*(check any that apply)

None
Sump Pump
Sauna
Hot Tub
Covered Deck/Patio
Wood Burning Stove
Central Air Conditioning
In-Ground Swimming Pool (not fenced)
In-Ground Swimming Pool (fenced)
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Are there any past claims?*(check any that apply)

None
Weather
Theft
Vandalism
Water
Fire
Other
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Home address:*

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City:*

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What is your full name?*

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What is your email address?*

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What is your phone number?*

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