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Homeowners Insurance Quotation

Welcome to our Homeowners Insurance quotation page.

For a free quote, fill out the secure form below and click submit. Please fill in as much of the information as possible to assist us in getting to you the most accurate quote. All information is held in the strictest confidence.

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Insured's Information

Your Name Street Address Street Address (continued) City State Zip Code Email Work Phone Home Phone Mobile Phone Your Birth Date Current Carrier Current Policy Expiration Date

Any losses within the last 5 years?

yes no if yes, please describe:

Building Information

Year built Total square feet

Number of stories

[ select one ] 1 1.5 2 split level other if other, please describe:

Construction type

[ select one ] Frame Masonry Brick other if other, please describe:

Roof Type

[ select one ] Tile Shingles Composition Tar & Gravel Wood Shake Concrete other if other, please describe:

Age of Roof

Substructure

[ select one ] Slab Crawl space Basement Post & Piers other if other, please describe:

Number of bathrooms

[ select one ] .5 1 1.5 2 2.5 3 3.5 4 4.5 other if other, please describe:

Number of fireplaces

[ select one ] 1 2 3 4 none other if other, please describe:

Garage [ select one ] none attached detached

Number of cars

[ select one ] 1 2 3 other if other, please describe:

Pool

yes no If pool yes, is it fenced or gated yes no

Air Conditioning

yes no

Central Heating

yes no

Wood Burning Stove

yes no

Burglar Alarm

yes no If yes, is the Burglar Alarm central or local? [ select one ] local central

Fire Alarm

yes no If yes, is the Fire Alarm central or local? [ select one ] local central

Gated Community

yes no

Plumbing Redone

[ select one ] Completely Partially None if done, what year:

Wiring Redone

[ select one ] Completely Partially None if done, what year:

Heating Redone

[ select one ] Completely Partially None if done, what year:

Please use this space to add any additional information How Did You Hear About Us? [ select one ]Internet Friend/Colleague Mailer Other

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Northern California

Toll free: 800-722-6606

1045 N. Fourth Street
San Jose, CA 95112
Tel: 408-298-9882
Fax: 408-298-9886

P.O. Box 837
Bodega Bay, CA 94923

Southern California

Toll free: 800-722-6606

P.O. Box 99593
San Diego, CA 92169

Toll free: 800-722-6606