License#: 0E67716
Home / Renters / Condo or Landlord Quote
Name:(first,last)
Copyright 2010 KIAC Insurance Agency: San Diego Auto Insurance. All Rights Reserved.
Date of Birth:
Spouse:
Date of Birth:
Property Address:
Is the mailing address the same as the property address?
(If no, explain in comments)
Policy Type:
Year acquired:
Year built:
Square footage:
Number of stories:
Age of roof:
# of bathrooms:
# of fireplaces:
Type of roof:
Garage:
Exterior wall:
Construction type:
Feet from fire hydrant:
Miles to fire station:
Air conditioning:
Heater type:
Gated community:
Exposure to hillside:
Exposure to brush:
If "Yes" distance to brush in feet:
Water heater in Garage:
Laundry room upstairs:
Swimming pool:
Jacuzzi:
Security alarm system:
Is it monitored?
Do you have any dogs:
If yes, name of breed if no, type in "NONE"
TYPE OF FLOOR COVERING (must add up to 100%)
% of brick:
% of carpet:
% of ceramic tile:
% of laminated:
% of marble:
% of hardwood:
% of slate:
% of other:
Comments:
How did you hear about us:
Your email address:
Preferred Method of Contact:.
Phone:
