Auto Health   Homeowners   Business   Workers comp   Contact us   About us   Location map   Glossary   Faq   Home Owners - Instant Quote   First Name   * Last Name   * Address of property to be Insured: Street   * City   * State   * Zip   * Daytime Phone Number   * (Including Area Code) Evening Phone Number   * Fax Number   * E-Mail   *   Reffered By ?  * PROPERTY INFORMATION Square Footage  500 600 700 800 900 1000 1100 1200 1300 1400 1500 1600 1700 1800 1900 2000 2100 2200 2300 2400 2500 2600 2700 2800 2900 3000 3100 3200 3300 3400 3500 3600 3700 3800 3900 4000 4100 4200 4300 4400 4500 4600 4700 4800 4900 5000 * Dwelling Value  * Year Built  1881 1882 1883 1884 1885 1886 1887 1888 1889 1890 1891 1892 1893 1894 1895 1896 1897 1898 1899 1900 1901 1902 1903 1904 1905 1906 1907 1908 1909 1910 1911 1912 1913 1914 1915 1916 1917 1918 1919 1920 1921 1922 1923 1924 1925 1926 1927 1928 1929 1930 1931 1932 1933 1934 1935 1936 1937 1938 1939 1940 1941 1942 1943 1944 1945 1946 1947 1948 1949 1950 1951 1952 1953 1954 1955 1956 1957 1958 1959 1960 1961 1962 1963 1964 1965 1966 1967 1968 1969 1970 1971 1972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 * Number of units  1 2 3 4 * Construction Type  Frame Masonry Superior Masonry Veneer * Roof Type  Metal Other Slate Tile Wood shake *   FIRE AND THEFT INFORMATION Over 1000 feet from a fire hydrant?   No Yes * Fire Department   South Lake Tahoe, El Dorado County Lake Valley FD, El Dorado County Fallen Leaf Lake FD, El Dorado County El Dorado Co, El Dorado County * Distance to nearest fire station   over 10 miles Within 5 miles 5-10 miles * Fire Extinguisher   No Yes * Smoke Detector   No Yes * Deadbolts  No Yes * Type of fire sprinklers   Full None Partial * Type of fire alarm   Central Local None Station * Type of theft alarm   Central Local None Station *       REQUESTED COVERAGES Liability coverage   $100,000 $300,000 $500,000 * Medical payments   $1,000 $10,000 $25,000 $5,000 * Policy deductible   1,000 250 2,500 500 *       POLICY INFORMATION Have you filed a previous homeowners claim?   Yes No * Date of last claim   * Current policy with   * Current policy Expires   *

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