Condo Insurance Quote
TWFG Landeche Insurance 504-228-7184
Insured Name
*
First Name
Last Name
Date of Birth
*
-
Month
-
Day
Year
Date
Email
*
example@example.com
Co-Applicate if any
First Name
Last Name
Date of Birth
-
Month
-
Day
Year
Date
Email
example@example.com
Property Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Is the Property Address the same as mailing address?
*
Yes
No
Mailing Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
By submitting your mobile number, you agree to receive periodic textmessages from us. Standard messaging rates may apply.
Format: (000) 000-0000.
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What type of Policy
*
Please Select
Condo
Condo and Flood
Landlord
Landlord and Flood
Flood Only
How much dwelling coverage would you like?
*
$ amount
How much personal property coverage?
*
$ amount
Do you have currently have Condo Insurance?
*
Yes
No
Is this a new Purchase?
*
Yes
No
What is the reason you did not have insurance?
*
What is the date you last had Condo insurance?
*
-
Month
-
Day
Year
Date
What is your current dwelling amount?
*
Current Insurance Company
*
Annual Premium
Date you would like coverage effective
*
-
Month
-
Day
Year
Date
Number claims in past 3 years *
*
Please Select
0
1
2
3
More then 3
Please give date of claim, amount of claim and cause of claim.
*
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Year Built
*
Square Feet
*
Construction
*
Please Select
Frame
Brick Veneer
Stucco
Hardi Plank
Brick (solid)
Vinyl
Foundation
*
Please Select
Slab
Raised
Stilts
Number of Stories
*
Please Select
1
2
3
4
Other
How many units in building
*
What story is the unit on
*
Number of Baths
*
Please Select
1
2
3
4
Number of Half Baths
Please Select
0
1
2
3
4
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Roof Material
*
Please Select
Architectural Shingles
Composition
Tile
Wood
Metal
Tar & Gravel
Roll Roof
Aluminum
Concreate
Type of Roof
*
Flat Roof
Gable Roof
Hip Roof
Roof Year
*
What year was the roof replaced?
Wiring year update?
*
Plumbing year update?
*
HVAC year update?
*
AC and Heating Sysyem
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Do you have a fire place?
*
Please Select
Yes
No
What Type?
*
Wood Burning
Gas
Eletric
Electrical
*
Please Select
Circuit Breaker
Fuses
Do you have a swimming pool
*
Please Select
Yes
No
Do you have a fenced in yard?
*
Please Select
Yes
No
Do you have a slide or diving board?
*
Please Select
No
Slide
Diving Board
Both
Do you have any dogs?
*
Please Select
Yes
No
How many?
*
What breed?
*
Do you need another type of insurance quote
*
Yes
No
Please Specify
*
How did you hear about us?
*
Google, Facebook, Bing and etc.
Do you have an insurance you would like to request?
*
First available agent
Ronald Landeche
Randy Tumminello
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