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Homeowners Insurance Quote
Please fill out this form. A customer services agent will contact you OR contact customer service directly at (636) 429-0001.
Date of Birth
Gated Community / Private Security / Secured Building
Is there a second insured? Name and relation to the primary.
Mailing Address OR "same"
Has customer lived at this address less than 60 days?
Will there be a multi-policy discount?
Resident type: Example, single family, multi-family, condo
# of Units
Is this the primary / secondary / rental / or seasonal residence?
Distance to nearest Fire Hydrant?
Distance to nearest fire station?
Does the insured financing the home or own it outright?
Does the insured wish to include payment in mortgage escrow?
Does insured have motorcycle, watercraft, snowmobile, golf cart?
Is there a hot tub or spa?
Is there a trampoline?
Are there dogs?
If yes to dogs, what are the breeds, names and is there any history of biting?
What will be the effective date of the policy?
Is there a burglar alarm? Is it a local or central alarm?
Does the home have dead bolt locks?
Is there a fire alarm?
Is there a fortification certificate?
Is there an interior sprinkler?
Is there a smoke alarm on each level?
Is there a fire extinguisher in the kitchen?
Was home purchased within the past year?
Is the home SMART connected?
Year the home was built?
Approximate square footage?
Garage information: # Attached garage space, # Detached garage space
# of stories to the home?
What is the type of exterior wall? Example, brick, aluminum siding, vinyl siding, frame...etc.
Type of foundation: Example, open, slab, crawl space, etc.
# of Baths?
Number of half baths?
Is there an open foundation?
Type of plumbing. PCV, brass, copper. Also include the year updated, if known.
Electrical: Type of wiring, example, aluminum, copper or other. Also include the date of upgrade if known.
Does the home have circuit breakers or fuses?
Does the home have greater than 100 amp capacity?
What type of roof? Example, architectural, asphalt, metal, 100 year, etc. Also include the year upgraded.
What is the pitch of the roof?
What type of heating does the home have? Example, gas, electric, wood burning, propane.
Is there a second type of heat?
Does the home have a fireplace?