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Texas Property Owners Insurance Quote One Simple Form - takes only 2-3 Minutes! Need Help? Phone 214-351-4097
Owners Information
*
Required Fields Coverage Type if Known
Name:
Recommend Coverage DP1 DP2 Fire Pollicy Fire EC VMM Dwelling Retail Structure Industrial
Business Entity Name:
Property Address:
City:
State:
Zip Code:
County:
Social Security or Tax ID number
Not Required, But may get you a lower rate
HO1 only issued without SSN
Date of Birth
if owner:
Date Established
if other
Email:
Phone:
Property Information
Year Built:
Property Type and Usage:
Single Family Dwelling Town House Multi Family Condo Unit Apartments Professional Building Retail Structure Industrial Manufacturing Small or Home Office Rented to others Owner Occupied Vacant
Approx Sq Ft.
Number of units:
1 2 Specify
Type of Construction
Brick WoodSteel Stucco Brick Veneer Aluminum Siding Stone Block Hollow Tile Abestos Siding Other Other
Type of Roof:
Composition Wood Shingles Metal Roof Aluminum Shingle Terra CottaSlate Tar and Gravel Rubber roof Other Other
Is there A Pool ?:
Yes No
If Yes, Is it
Fenced or Gated Yes No
Is the property within 500 ft of a lake, pond or large body of water?
Nearest Fire Station:
Select Miles123456Over 6 Miles Distance to fire hydrant 0 - 500 ft501 - 1000more than 1000None
Prior Claims? :
If Yes, Please describe in Detail any claims
for the last 5 years
How is your Credit History?
Good CreditFair CreditPoor CreditBad Credit
(Some Carriers use credit history to quote)
( Bad Credit is OK, We have programs for all)
Protective Devices?
None Burglar / Fire Monitored Alarm Burglar Monitored Alarm Fire Monitored Alarm Burglar Local Alarm Fire Local Alarm Burglar / Fire Local Alarm
Home Updates?
Roof
Electrical
Plumbing
AC / Heat
Currently Insured?
Current Insurance Co. Name?
Current Annual Premium?
Expiration Date?
Coverage Requested
Property Coverage.
Property Value
$
Unscheduled Contents $
Default is 25 K Non Luxury items
Liability Coverage.
$0.00$25,000$100,000$200,000$300,000$500,000$1,000,000
Loss of use Revenue Coverage
None 10 percent $100,000 $200,000 $300,000 $500,000 1 Mil
Desired Coverage Valuation Method
Market Value - ACV Replacement Cost Recommend Coverage
Hurricane Coverage Needed?
Desired Deductible:
1 % 2 %
Comments / Remarks (Describe any additional information you feel may be helpful in determining your quote).
My preferred Contact :
* Email Call by Phone
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Disclaimer Notice: - The premiums quoted are estimates based in the information you provided. If you have any questions or other pertinent information you feel necessary to properly quote your insurance Please feel free to contact our office at the number above for a personalized quote.
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