Home owners quote

Home details
Square footage of your home (living space)*
Protection Class (may be on declaration page)
Leave blank if you don't know
Distance to the Fire Department?
Number of miles from you home.
How many feet to the nearest Fire Hydrant?
Estimate distance
Purchase date of home*

MonthDayYear
Date
# of Stories (not including basement)*
Garage Details*
Foundation Type*
If you selected basement list what percentage is finished
Exterior of the House*

BrickVinyl sidingWood sidingStoneOther
Roofing Material *
Last Year roof was updated (best of your knowledge)*

MonthDayYear
This used to determine how old the roof is.
# of Bedrooms*
# of Full Baths*

Build type of (Full) Bathroom*

Build type of (Half) bathroom

Build type of Kitchen *

	Builders Grade	Custom	Designer
#1
#2

Kitchen Countertops*

MarbleGraniteComposite
Type of Fireplace*
Flooring type If choosing multiple selections list % amount under other

CarpetHardwoodVinylTileOther
Patio/Deck*
Square footage of patio/deck
Type of Heat*
Last year heating unit was replaced (only year needed)*

MonthDayYear
Date
Electrical*
Type of Plumbing Pipes (List any updates done)

Number of animals

Alarm

	Monitored (3rd Party)	Central (Direct to police station)	Local (audible sound only)	Smart Device (monitored)
Alarm system
Fire alarm
Sump pump

Additional coverages
Coverage needed for Jewelry? blanks Please list the value amountblank
Water Back-up Coverage*
Sump Pump*
Are there any boats or recreational vehicles covered under a separate policy?
Any additional vehicles (boats-campers-motorcycles-ect)

BoatCamper/RVMotorcycleTrailersOther
Additional comments regarding updates or special features including any additions to be covered.