Step 1 of 3 33% Home/Renter Quote Fact FindName*Property Address* Street Address City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Home Phone*Work Phone*Best Time to Call*Year BuiltSquare FootagePlumbing TypeExterior Wall Type Wood Siding Aluminum/Vinyl Siding Brick Veneer Stone Veneer Stucco on Frame Solid Brick Solid Stone Asbestos Shingle Wood Shake Paint on Masonry Stucco Masonry Adobe Roof Type Comp Shingle Concrete Tile Wood Shingle Wood Shake/Spanish Tile Slate/Copper Age of RoofShape of Roof# of Units Kind of Heating System?Fuel TypeFuses or Circuit Breaker?AmperageDogs?Claims You Filed in 3 Yrs?Water Claims on Property in 3 YrsAny smokers?YesNoAuto/Home Discount?YesNoProtective Devices Deadbolts Central Alarm Fire Extinguisher Local Burglar Alarm Working Smoke Alarm Sprinkler Dwelling Type One Story 1 1/2 Story Two Story Split Level Interior Wall Type Drywall/Sheetrock Plaster Type of Garage 1-Car 2-Car 3-Car Attached Built-In Carport None Kitchen Type Economy Standard Custom Luxury BasementYesNo% of Ground Floor% FinishedNumber of BathsBath Type Economy Standard Custom Luxury Shower StallYesNoNumber of FireplacesNumber of Wood Burning StovesNumber of Garage OpenersAir Conditioning?YesNoSeparate Structures?YesNoIf yes, Type:Sq. Footage# of DecksPorch OpenYesNoPorch ScreenedYesNoBreezeway OpenYesNoBreezeway ScreenedYesNo Additional FeaturesGreenhouses?YesNoScreen Pool Enclosure?YesNoSolar Panels?YesNoStained Glass?YesNoSauna?YesNoSpiral Staircase?YesNoOmamental Stairs?YesNoElectric Air Cleaner?YesNoCentral Vacuum?YesNoLaundry Tub?YesNoIndoor BBQ?YesNoIntercom System?YesNoAdditional Furnace?YesNoTrash Compactor?YesNo# of SkylightsYesNo# of Exterior ShuttersYesNo# of Interior ShuttersYesNo# of Wet BarYesNo# of JacuzziYesNoExtras to be included?Extras to be included? Computer Coverage Jewelry Theft Coverage Any Floaters Flood Insurance Earthquake Insurance Increased Coverage for Separate Dwellings Increased PP Coverage First Response Fire DeptPersonal PropertyCurrent Dwelling CoveragePersonal LiabilityDeductibleName & Address of Mortgage Co.
