Owner and Property Basics

Start with the owner, contact information, property address, and occupancy.

Name

Property Held In

Entity / Business Name

Email

Phone

Preferred Contact Method

Property Address

City

State

ZIP

What Are You Insuring?

Property Usage

Why is the property vacant?

How long has it been vacant?

Is it being renovated?

Are utilities currently on?

How often is the property checked?

Expected Occupancy Date (optional)

Multiple Properties to Insure?

Portfolio Quote Interest

Property Details

Provide the building details commonly used to review eligibility and coverage.

Year Built

Purchase Date (optional)

Approx. Square Feet

Number of Stories

Number of Units

Garage / Parking

Construction Type

Other Construction

Roof Type

Other Roof Type

Roof Age

Short-Term Rental Exposure

Swimming Pool?

Is the Pool Fenced or Gated?

Within 500 ft of a Lake, Pond, or Large Body of Water?

Need Coverage for Detached Structures?

Detached Structure Notes (optional)

Coverage and Insurance History

Tell us what you need, when coverage is needed, and whether the property has current insurance or prior claims.

Coverage Preference

When Is Coverage Needed?

Property Value / Coverage Goal (optional)

Deductible Preference (optional)

Target Premium Range

Currently Insured?

Current Insurance Company

Any Prior Claims?

Biggest Concern Today

Claim 1 Type

Claim 1 Date

Amount Paid (optional)

Claim 2 Type (optional)

Claim 2 Date (optional)

Amount Paid (optional)

Final Property Details

Optional information can help us review the quote with fewer follow-up questions.

Major Updates in the Last 10 Years (optional)

Roof Electrical Plumbing HVAC

Protective Devices (optional)

Monitored Burglar Alarm Monitored Fire Alarm Local Alarm None

Tenant Occupancy (optional)

Pets or Liability Concerns? (optional)

Optional Protection Interests (optional)

Loss of Rents Water Backup Ordinance or Law Equipment Breakdown

Anything Else We Should Know? (optional)

Submitting this form requests an insurance quote. Coverage is not bound until confirmed by an authorized insurance representative or provider.

Landlord Property Quote Request

Owner and Property Basics

Property Details

Coverage and Insurance History

Final Property Details

Prefer to Talk With an Agent?