Condo Insurance Quote

First Named Insured    DOB: //19

Second Named Insured      DOB: //19
 
Address: 
 
 City:                                           State:       Zip: 
                          
Phone: 
 
 Fax:     
 
 Email:  
 

Condo Information

Year Built: (ex. 2005)                      Number of Units in Building:

Construction Type:         Square Foot:

If the condo was built over 25 years ago, please answer the following 4 (four) questions:

Year Updated:   Roof:     Furnace:     Electrical:     Plumbing:

Basement:         If yes, is it finished:         Square Foot of Finished Basement:

Burglar Alarm        Fire Alarm

Coverage

A. Dwelling / Interior Fixtures $       Replacement Cost:    Dwelling: Contents:

(i.e. kitchen cabinets, bathroom fixtures, carpeting, etc.)

C. Personal Property $                    

D. Loss of Use $                      Scheduled Items (ex. jewelry, fine arts, firearms):

E. Personal Liability $                      

F. Medical Pay $                                  Deductible:

3-Year Loss History (Include date and description):

Date: //        Description:

Date: //        Description:

Date: //        Description:

 

 

 Is there anything else we should know regarding your condo insurance?

 

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