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About Your Home

Address: 

City: 

State: 

Zip: 

Dwelling’s Current limit of Insurance:

Square Footage W/O Garage: 

Year Built: 

Number of Units:Single FamilyDuplexTriplexFourplex

Number of Stories:OneTwoThree+

Construction Type:[select "Frame" "Masonry"]

Occupancy:PrimarySecondaryTenantSeasonal

Roof Type:CompositeTileShakeOther

Liability Limit:$300,000$500,000$1,000,000

Medical Payments:$500$1,000$2,000$5,000

Deductible:$500$1,000$1,500$2,500

How many losses or claims have you had in the past 3 years?:0123+

Additional Information

Do you have any special requirements of your insurance?:  Jewelry Guns Fine Art Furs Other

Rating Information – Property Attributes

 Over 1000 feet from a hydrant FIRE STATION: Over 5 to 10 mi FIRE STATION: Over 10 mi Brush Hazard Smoke Alarm Fire Extinguisher Deadbolts SPRINKLERS: Partial SPRINKLERS: Full THEFT ALARM: Local THEFT ALARM: Station THEFT ALARM: Central FIRE ALARM: Local FIRE ALARM: Station FIRE ALARM: Central Gated Community