Home Insurance Quote - GIS - Greater Insurance Service, Independent Insurance Agency, Insurance

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HOMEOWNERS INSURANCE QUOTE

WE PROVIDE INSURANCE COVERAGE FOR MINNESOTA ONLY
To obtain a FREE, no obligation quote for Homeowners Insurance, fill out the form below and we will contact you. If you prefer to give information over the phone, fill out the * areas only and we will give you a call, or print this out and mail or fax it to us.

Name:	*
Address:	*
City:	*
State:	*
ZIP:	*
Home Phone:	*
Email:	*
Work Phone:
Cell Phone:
Many of the companies we represent require the following information prior to providing a firm quote. To provide an accurate quote we need to ask questions about yourself and members of your family. The information collected enables us to receive information from consumer reporting agencies, motor vehicle departments, and inspection services. This information is available to the insurance companies who provide the insurance rates used in the quoting process.
Occupation(s): Present Insurance Company: Renewal Date of Current Policy: Present Coverage Limit on Dwelling: $ Present Coverage Limit on Contents: $ Present Coverage Limits on Other Structures: $ Liability: 100,000 300,000 500,000 1,000,000 Present Coverage Limit on Medical Payments: 1,000 2,000 3,000 5,000 10,000 Current Deductible: 100 250 500 1,000 Have you had any claims/payments made to you or others by your homeowner's insurance policy? 0 1 2 3 4 5 Please describe the claims: Exterior dimensions of your house: Total square footage of your homes main floor: Home: 1 story 1-1/2 story 2 story Split-level Construction: Frame or Stucco Masonry or Brick Veneer Foundation: Basement Crawlspace Slab Roof: Asphalt Shingles Wood Shingles Metal Garage: 1 Car 2 Car 3 Car 4 Car Other Features: Central Air Conditioning Whirlpool Tub Sauna Below Ground Pool Fireplace Wood Heating Device Finished Basement sq ft of finished basement Deck sq footage of deck Porch sq footage of porch List any other features not identified above: Home Updates: Roof Age: Siding Age: Plumbing Age: Electrical Age: Furnace Age: Type of Furnace: Forced Air Hot Water Electrical Wood

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