Farmers Insurance
At the Weaver-Hammann Agency, it is our goal to provide you with personal, no-nonsense service. Eric and Cody and team want you to have peace of mind in your coverage. We are licensed in MO and KS, and we offer coverage options for you all of your needs.
Thank you for submitting your information for a quote! We are looking forward to connecting soon.
contact@weaver-hammann.com l 816-858-3650 l Platte City, MO
Please provide information for all household drivers.
Name
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First Name
Last Name
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Please Confirm a Valid Email
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Please confirm your Date of Birth
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Month
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Day
Year
Date
Drivers License
Number
State Issued
Marital Status
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Married
Domestic Partner
Single
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Spouse or Domestic Partner Name
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First Name
Last Name
Spouse's Date of Birth
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Month
-
Day
Year
Date
Do you have any additional drivers?
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Yes
No
Additional Driver 1
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First Name
Last Name
Date of Birth
Additional Driver 2 (Leave Blank if Not Needed)
First Name
Last Name
Date of Birth
Additional Driver 3 (Leave Blank if Not Needed)
First Name
Last Name
Date of Birth
Additional Driver 4 (Leave Blank if Not Needed)
First Name
Last Name
Date of Birth
Farmers offers many discounts for certain occupation groups and degrees attained. If you're willing to share, please choose an option below so that we can try to save you the most!
Please Select
Accountant
Architect
Aviator
Dentist
Educator
Engineer
Farmers Employee
Fire Fighter
Law Enforcement
Lawyer
Librarian
Military
Physician/RN/LPN
Scientist
Science Bachelors
Science Masters
PHD
Please choose one. If multiple options are available, please let us know when we meet!
Farmers also partners with many companies to offer discounts, if you're willing please list your employer so we can check for discounts!
Please list companies for all adult drivers.
Please list the vehicles you'd like us to quote.
Vehicle 1
*
Year
Make
Model
Do you have any additional vehicles?
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Yes, More than One More Vehicle
Yes, One More Vehicle
No
Vehicle 2
Year
Make
Model
Vehicle 3
Year
Make
Model
Vehicle 4
Year
Make
Model
Vehicle 5
Year
Make
Model
Please provide information about your dwelling.
Please Confirm your Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Do you rent or own your dwelling?
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Rent
Own
Home Type
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Traditional Site Built Home
Mobile/Manufactured Home
Other
What size is your Mobile/Manufactured Home?
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What year was the Mobile/Manufactured Home built?
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What is the value of your Mobile/Manufactured Home?
*
How do you pay your home insurance?
*
Please Select
Escrow
Monthly
Every 6 Months
Annually
Rent-to-Own (Owner carries Insurance)
How long have you lived in your home?
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Please Select
Prior to 1980
1980
1981
1982
1983
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
2018
2019
2020
2021
2022
How many Sq Ft is your home?
*
Estimate is Fine
What year was your Roof Installed?
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Please Select
Not Sure
More than 15 years ago
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
2018
2019
2020
2021
2022
What type of Roof do you have?
*
Please Select
Asphalt Shingle
Metal
Wood Shingle
Clay Tile
Flat
Other
Do you know when your Heating and Cooling was updated?
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Please Select
Not Sure
More than 15 years ago
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
2018
2019
2020
2021
2022
What type of Flooring do you Have?
*
Please Select
Carpet
Tile
Laminate
Vinyl
Hardwood
Other
Do you have a basement?
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Please Select
Yes, Finished
Yes, Not Finished
No
Do you have a Pool?
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Please Select
Yes, Enclosed
Yes, Not Enclosed
Yes, Above Ground
No
Do you have a Trampoline?
*
Please Select
Yes, Enclosed
Yes, Not Enclosed
No
Do you have any dogs
*
Please Select
Yes
No
Do you have any other structures?
*
Please Select
No
Detached Garage
Detached Carport
Detached Shed
Metal Out-Building
Wood Barn
Greenhouse
Other
Recreational Vehicle Information
Do you have any recreational vehicles?
*
Yes
No
Please check your specialty/recreational vehicles.
Motorcycle
ATV & Off-Road
Boat & Watercraft
Collectible Auto
RV & Motor Home
5th Wheel
Travel Trailer
Other
Current Insurance Information
Are you Currently Insured?
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Yes
No
Who are you currently insured with?
*
If your home and auto are with separate companies, please list both.
What is your current company charging you?
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If your home and auto are with separate companies, please list both.
What is most important to you when choosing insurance?
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Coverage
Deductibles
Service
Accessibility
Price
Other
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