Homeowners Insurance Quote

Your desired office of service: -specify- Rio Grande, New Mexico: Santa Fe Rio Grande, New Mexico: Espanola Rio Grande, New Mexico: Albuquerque Rio Grande, New Mexico: Las Cruces Rio Grande, New Mexico: Los Lunas Rio Grande, New Mexico: Taos Rio Grande, New Mexico: Alamogordo Film & Internet Division Rio Grande, New Mexico: Life & Health Division Rio Grande, Arizona: Phoenix Office Rio Grande, Arizona: Scottsdale Office Rio Grande, Arizona: Chandler Office Rio Grande, California: Southern California Rio Grande, California: Sacramento Office Rio Grande, Utah Doesn't Matter I Don't Know (please select one before continuing)

Please provide the following information about you and your property to be insured:

Please provide the type(s) of insurance coverage desired (check all that apply, you must select at least one):

What is your desired effective date for this coverage?  

Are you within the city limits?   Yes   No

Is there a mortgage on the property ?   Yes   No

Is there a 2nd or 3rd mortgage, line of credit or co-signer on mortgage of property?   Yes   No
If yes, please describe in comments below

What year was your property built?  

Please indicate the primary construction type of your property:  -specify- frame masonry/adobe metal other (describe below)

Garage type:  -specify- none attached 3+ car attached 2 car attached 1 car detached 3+ car detached 2 car detached 1 car

What is the total heated square footage of your property?  (do not include garage)

What is your desired replacement cost coverage for your home's main structure? 

How much is your home replacement cost currently insured for, if different from above? 

Desired All-Perils Deductible:  -specify- $250 $500 $1,000 $2,000 $3,000 $4,000 $5,000

Desired Liability Coverage:  -specify- No Coverage $25,000 $50,000 $100,000 $200,000 $300,000 $400,000 $500,000

Desired Medical Payments Coverage, per person:  -specify- No Coverage $500 $1,000 $2,000 $3,000 $4,000 $5,000

Approximate distance to nearest fire station (in miles) 

Approximate distance to nearest fire hydrant (in feet) 

Please indicate the main type of heating system:  -specify- gas wall units gas floor units gas forced air Electric forced air Electric baseboard Hot water baseboard radiant floor - water radiant floor - electric Freestanding wood stove Space Heaters Passive Solar Active Solar other (describe below)
If there is any additional type of heating, please describe in the comments box at the bottom

Please indicate the type of roofing material:  -specify- built up tar & gravel shingles metal urethane/plastic/membrane other (describe below) If other, describe below
What year was your roof last replaced?  (most companies need to see a roof replaced within last 10 years)

Type of foundation:  -specify- slab crawlspace basement walk-out other (describe below)

Number of Stories   -specify- 1 (ground floor only) 1 with basement 1 1/2 Split Level 2 more than 2 split levels other (you must describe below) none

Do you have a wood stove or a fireplace? (if both, explain below)  -specify- wood stove fireplace multiple fireplaces Both a woodstove and one or more fireplaces other none

What type of animal(s) do you have on the property?  -specify- dog(s) cat(s) bird(s) other
Is your animal considered dangerous?   Yes  No

Is this property currently insured in your name?   Yes  No
      If Yes, with which company:
      what is your current approximate annual premium: $.00

      If No, when was the last date you had insurance on this property: REQUIRED INFO!
If this property is not currently insured, YOU MUST EXPLAIN why in the comments box at the bottom

Is there a home based business on the property?   Yes   No
      If Yes, please describe:
      How many people visit your business per week:
      Do you need more than $250 of business property coverage?   Yes   No

Have you had any losses or claims in the past five years?  Yes  No
      If Yes, what type (water, theft, etc.):
      If Yes, how much did you receive from your insurance: $.00
      If Yes, what was the date(s) of loss/claim:

Is this a business property quote ?   Yes
      If Yes, name of business:
      If Yes, type of business:
      If Yes, legal structure of business:
      If Yes, Federal Tax ID # of business:

Mobile Home Specific Questions

      Is mobile home in an approved mobile home park?   Yes (If so, put name of park in comments below)
      Model Year:
      Width (in feet):
      Length (in feet):
      Is mobile home tied down?   Yes

ADDITIONAL ENDORSEMENTS

Are you interested to know the costs of: