Condominium Insurance

For California residents only.

Just How Safe Are Your Belongings?

Someone's home is being burglarized every 10 seconds!

After you've completed this form, click on the SUBMIT button to receive your free Condominium Insurance quote. You'll be given an opportunity to specify U.S. Postal Service, e-mail or fax. Or phone (760) 644-0351.

Customer Information
Name
E-mail
Street address
City
County
State
Zip Code
Home Phone
Work Phone
FAX

Address of Property (if different from above):
Address
City
County
State
ZipCode

Condominium Building Description
Number of Units in Bldg.	Age 55 & Retired	Inside City Limits?	Year Built	Central & Alarm Systems (Select all that apply)
	Yes No	Yes No		Smoke Alarms Fire Extinguisher     Dead Bolts       24 Hour Guard        Central Station Burglar Alarm

Requested Coverages
Value of Contents (Minimum $31,000)	Liability	Deductible	Loss Assessments	Earthquake Cov. Wanted?
	-- select -- $100,000 $300,000 $500,000 $1,000,000	-- select -- $500 $1,000	Yes No	Yes No

Do you have any Jewelry, Fine Arts, Sporting Equipment or Collections which may need special "ALL RISK" Coverage?

Underwriting Information
Current Insurance
Expiration Date
Breed of Dogs?
Losses within the last 5 years?

Reporting Method
How would you like to receive your free Condominium Insurance quote?	U.S.Postal E-mail Fax

 

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