Alport Insurance Agencies Inc.
Homeowners quote Information
Owner(s)
*
Contact number
*
-
Area Code
Phone Number
# of years claims free
# of years insured
Square feet (not including basement)
Address
*
Year built
Earthquake coverage?
YES
NO
Detached
YES
NO
Continuous Foundation
YES
NO
Physical Shape of House
Single Family
Yes
No
Single Family
Yes
No
Exterior Finish
Heating
Type
Age
Oil Tank
Yes
No
Hot Water tank age
Oil Tank Type
Electrical updates?
YES
NO
Electrical update
Year
Percentage Updated
Wiring
Type
Amps
Roof
Age
Type
Plumbing upgrades?
YES
NO
Plumbing upgrade
Year
Percentage Updated
# of bathrooms
Full
Half
Woodstove?
YES
NO
WETT inspected?
YES
NO
Attached garage (cars)
Square feet of Deck
Deck Type
Open
Closed
Square feet of Porch
Porch Type
Open
Closed
Square feet of other area
Square feet of Basement
Basement Condtion
Finished
Partially Finished
Unfinished
How much is finished (%)
Type of Basement
Interior Sprinklers
Yes
No
Consent for soft credit check?
Yes
No
Mortgage
Deductible
# of Smoke dectectors
Sercuity Alarm?
Type of Alarm
Local
Monitored
Outbuilding(s)?
Yes
No
Square feet of Outbuilding(s)
Boarders?
Yes
No
Business use in home?
Yes
No
Type of busines
Pool or hot tub?
Pool
Hot tub
Pool details
Hot tub details
Is home vacant any portion of year?
Previous Insurer
Policy number
Effective date?
Submit
Should be Empty: