What is the basic construction?

Frame Masonry Masonry-Veneer Superior

What type of residence is this?

Single Family Residence Duplex Triplex Fourplex Apartment Townhouse Condominium

How many units are there?

Type of Fire Alarm:

None Central Station Fire Department Local

Type of Burglar Alarm:

None Central Station Police Department Local

Select Discounts that apply:

Is one of the people named as an insured over age 58, retired and living in the household?

 Yes     No   

Value of contents to be insured:

Coverage for loss of use:

Personal liability coverage:

100,000 200,000 250,000 300,000 400,000 500,000 1,000,000

Medical payments:

1,000 2,000 2,500 3,000 4,000 5,000 10,000 25,000 50,000

Select your deductible:

100 100/250 250 500 750 1,000 1,500 2,000 2,500 5,000 7,500 10,000 25,000

Iinterested in the Renter/Auto Discount?

 Yes     No   

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