• Home Quote Sheet

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  • Thank you for your interest in Cheney Insurance.

    Providing the most accurate and up-to-date information about your home allows us to obtain a quote that reflects its appropriate replacement cost and helps ensure you receive all applicable discounts and credits offered by our insurance carriers. The more accurate the information, the better we can help protect your home and find the coverage that best fits your needs.

    You can save your progress at any time and return to the form.  

    A member of our team will respond to all quote requests within 24 business hours.

  • Is your mailing address different than the physical address*
  • Format: (000) 000-0000.

  • Please list all people that are listed on the deed.  If you need more space, you can add in the comments section.  We will need all deeded owners' Social Security numbers.  If you are not comfortable giving this information online, we can gather that information over the phone. 

  • Date of Birth*
     - -
    2 digit month, 2 digit day, 4 digit year
  • Date of Birth
     - -
    2 digit month, 2 digit day, 4 digit year
  • Is this the home:*
  • Do you rent the property or participate in Airbnb, VRBO or any other rental platforms?*
  • Do you currently have insurance coverage on the dwelling?*
  • Has there been any claims/losses in the last 5 years?*
  • Is there a Mortgage/Home Equity Loan on the property?*
  • Will be there any construction and or renovations on the property?*
  • The property is:*
  • What is the style of the property:*
  • Is it:
  • Construction Type:*

  • For the next two questions regarding your kitchen and bathrooms, please indicate whether the cabinets are builder-grade or custom.

    Builder-grade cabinets are standard, factory-made cabinets that can typically be purchased and replaced through home improvement stores such as Lowe's or Home Depot. Custom cabinets are built specifically for your home by a cabinet maker or custom woodworking company and are designed to fit your space and specifications.

  • Kitchen Cabinets:*
  • Bathroom Cabinets:*
  • How many full bathrooms?*
  • How many half bathrooms?*
  • What is the exterior siding?*
  • What is the roof construction?*
  • Was the roof:*
  • Are there any skylights?*
  • What is the wall material? Please check all that apply.*
  • What are the wall coverings? Please check all that apply.*
  • What is the flooring?*
  • Is there a basement and a sump pump? Please check all that apply
  • Is the plumbing:*
  • Was the last update to plumbing:*
  • Is the electrical*
  • Was the last update to electrical:*
  • Heating System: Check all that apply.*
  • Was the last update to heating system:*
  • Where is the tank located?*
  • How many wood stoves in the home?*
  • Does the home have any of the following:*
  • How many fireplaces in the home and are they gas or wood?*

  • Many insurance companies offer discounts for features that help protect your home or reduce the risk of a claim. If your home has any of the following safety or protective devices, you may be eligible for credits on your homeowners insurance. Please answer the questions below as accurately as possible. Choose all that apply.  

    If you have a Central Alarm System, the insurance company may want proof and you will need to provide a certificate as documentation.

  • Does the home have any of the following: Check all that apply.
  • Are there any smokers in the home?*
  • Do you have a low temperature alarm? (Required for secondary homes)*
  • Do you have a water shut off system?*
  • Does the home have a caretaker?*
  • Is the home accessible to Emergency Vehicles year round?*
  • If a secondary home, is the home professionally winterized?*
  • Do you have any of the following:*
  • Do you have any of the following*
  • Are there any detached structures?*

  • You are on the home stretch. Just a couple of more questions followed by important follow up information for your home quote!

  • Do you have any dogs?*
  • Do any of your dogs have a bite history?*
  • Do you have any farm animals on your property?*
  • Do you have any buildings for hay storage?*
  • Do you have any of the following on the premises?*
  • Is there any business conducted on the property?*
  • Are there any signs for your business on the property?*
  • Is your business currently insured?
  • Is there foot traffic for your business?
  • Is there any cannabis growing exposure on the premises?*
  • Is there a pool, hot tub or trampoline on the premises?*
  • Is there any Coastal Exposure? (i.e. subject to flood, wave wash, windstorm)*
  • Do you have any items that you would like to specifically schedule on your policy? Such as valuable art, jewelry, antiques? We will need a copy of a formal appraisal to schedule any items for an extra layer of protection. You agent will review this with you.*
  • Would you like to try and bundle any of the following with the home insurance:*
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  • Submitting this form is a request for an insurance quote only. Completion of this form does not create or bind insurance coverage, and no insurance coverage is in effect until your application has been reviewed, approved by the insurance carrier, and you have received written confirmation from Cheney Insurance that coverage has been bound.

  • Date
     - -
    2 digit month, 2 digit day, 4 digit year
  • Should be Empty: