Homeowners Insurance Estimate
To secure a reliable estimate, please complete as much of the form as possible.
The more information you provide, the better premium we can offer.
Use comments section for additional information.


Personal Information

Name Date of Birth
Address
City State    ZIP
Home Phone Work Phone
E-Mail Address
Current Homeowners Insurance Company
Present Coverage Amount
Renewal Date
Occupation
Claims in Last 3 Years
Inside City Limits Yes    No Township
(if known)
Does anyone smoke in the household? Yes    No County



Dwelling Information

Square Footage - Living Space
Year Home Built How many years at this address?
Type of Dwelling Distance from fire dept. (miles)
Building Design Distance from fire hydrant (feet)
Construction
Foundation
Roof Roof Age
Basement Finished Sq. Ft.
Fireplace Yes    No
Wood Burner Yes    No
Central Air Conditioning Yes    No
Whirlpool Tub Yes    No
Trampolines Yes    No
Deck Sq. Ft.
Porch Sq. Ft.
Number of Dogs Breeds
Primary Mortgage Yes    No Who with?


Comments

Many people prefer to fax us a copy of their current policy deck sheets.
Some send them as an e-mail attachment. If you wish, please do so. It
makes our quote more accurate. Be sure to send both sides. Our 24-hour
fax is (517) 546-9943. We also have group discounts. If you belong to
an alumni group or you or your spouse is eligible to join one, let us know.
Some other groups (often based on employment) offer discounts.
Ask us if your group is included.

Please click on the Submit button to send your estimate request.
This is not an application for insurance, and it does not obligate
this agency to issue any policy of insurance.