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Homeowners Insurance Quote
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PRIOR INSURANCE
   
Prior insurance company:
Have Insurance with them for*
Estimated Yearly Premium (in US$)
Prior Policy Ends On*
 
 
PROPERTY GENERAL
  
Property Surroundings*
Distance to Fire Station*
Distance to Hydrant(ft)*
Year Built*
Property Use*
Square Footage*
Number of Families*
Number of Stories*
Dog Type*
 
PROPERTY VALUES
Est. Current Market Value*
Est. Replacement Value*
 
CONSTRUCTION DETAILS
Construction Type*
Roofing Material*
Age of Roof
Electrical Type*
Heat Type*
Number of Fireplaces*
Number of Bathrooms*
 

PROTECTION DEVICES
Burglar Alarm*
Fire Alarm*
Smoke Detectors*
Fire Extinguishers on Each Floor*
Fire Sprinkler System*
  
Coverages 
  
Dwelling$
Sep Structures $
Personal Property$
Loss of use$
Personal liability$
Guest Medical
  


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