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--Our Affiliates--
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--GROUP--
health insurance
life insurance
disability insurance
dental insurance
vision insurance
--INDIVIDUAL--
health insurance
life insurance
disability insurance
dental insurance
long term care insurance
WHAT IS SUPPLEMENTAL INSURANCE?
accident & sickness
cancer
hospital indemnity
short term disability
intensive care
term life
--PERSONAL LINES--
homeowners insurance
automobile insurance
dwelling fire policy
recreational vehicles, boats, &
motorcycles insurance
--COMMERCIAL LINES--
business property & liability
commercial auto
bonds
other
Home
>
Property & Casualty Insurance
>
Personal Lines
> Homeowners Insurance
Because your home is one of the largest investments that you have and we are here to protect your assets, we prefer to discuss your insurance needs rather than give you a quote over the Internet. There are several variables that go in to quoting insurance and some of that is personal information that you may not want to send over the Internet.
Please complete the initial information below to begin our evaluation and we will contact you to discuss your insurance options.
Disclaimer
: Presently, we are writing/quoting business in Michigan only for property and casualty lines of business.
Fields marked with
*
are required.
PERSONAL INFORMATION:
NAME:
*
SPOUSE'S NAME:
*
CHILDREN OF DRIVING AGE
ADDRESS
*
City
*
STATES WHERE WE WRITE BUSINESS
CHOOSE THE STATE OF YOUR PRIMARY RESIDENCE
Arizona
Georgia
Michigan
*
ZIP CODE
*
PHONE
*
BEST TIME TO CONTACT
AM
PM
CURRENT CARRIER:
NAME OF CARRIER
INSURANCE EXPIRATION DATE
HAVE THERE BEEN ANY CLAIMS IN THE LAST 5 YEARS?
Yes
No
HOME INFORMATION:
To assure that you are properly covered, we will need you to answer the following questions:
MARKET VALUE:
IS THE PROPERTY USED FOR FARMING?
Yes
No
IS THE PREMISE USED FOR ANY BUSINESS ACTIVITY?
Yes
No
ARE THERE ANY OUTBUILDINGS (POLE BARN, GUEST HOUSE, BARN)?
Yes
No
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