Apartment Condo Insurance Quote - Laura Harris Agency Inc. of Texas

Laura Harris Agency Inc.
Professional Service

5350 S Staples St Suite 150 Corpus Christi, TX 78411 361-985-2875 361-985-0509 (fax)
email:dawneperez@allstate.com
Our agency is licensed to quote and write insurance policies only in Texas. To find agents offering these coverages in all other states, please click the IQ.net logo.

Personal Details -
The following information is required for our agency to quote

Name

Address

City

State

Zip Code

Day Phone

Evening Phone

email Address

Location Details

Yes No Not sure

Is there a fire house with 5 miles of your home?

Is there a fire hydrant within 1000 feet of your home?

Do you have a monitored central alarm?

Condominium Owner/Tenant Insurance Questions

Have you made any permanently attached improvements. In a condo bookselves, new cabinets or wall to wall carpeting etc are normally your responsibility. If so what is the value of such improvements.

What is the estimated replacement value of the contents of your dwelling?

Have you made any permanently attached improvements? In a condo bookshelves, new cabinets or wall to wall carpeting etc are normally your responsibility. If so what is the value of such improvements.

Dwelling type?

Do you operate a business from your home?

Yes No
If yes please describe in the remarks section

Coverage Questions

What deductible would you like for your home owners policy?

Current or Desired Contents Limit
Replacement Cost Included? Yes No

Do you have high vale items listed and insured separately?
Yes No

Please specify details in the remarks section.

What amount of liability coverage do you want?

Do you currently have a policy in force?
Yes No

If Yes, what month does your policy expire?

Claim History

Have you made any claims on a dwelling insurance policiy in the last 5 years? Yes No

Description of Claims

Date of claim Cause Amount

Remarks
Please enter any additional information that you think may assist us in providing you with a faster and more accurate quote.

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Page Created 4-29-02


Latest Revision

Name
Address
City
State
Zip Code

Day Phone
Evening Phone
email Address

	Yes	No	Not sure
Is there a fire house with 5 miles of your home?
Is there a fire hydrant within 1000 feet of your home?
Do you have a monitored central alarm?

What is the estimated replacement value of the contents of your dwelling?
Have you made any permanently attached improvements? In a condo bookshelves, new cabinets or wall to wall carpeting etc are normally your responsibility. If so what is the value of such improvements.
Dwelling type?
Do you operate a business from your home?	Yes No If yes please describe in the remarks section

What deductible would you like for your home owners policy?
Current or Desired Contents Limit	Replacement Cost Included?	Yes No
Do you have high vale items listed and insured separately?	Yes No
Please specify details in the remarks section.
What amount of liability coverage do you want?
Do you currently have a policy in force?	Yes No
If Yes, what month does your policy expire?

Date of claim	Cause	Amount