HOMEOWNERS RENEWAL QUESTIONNAIRE

Please update the information below.

Many of our carriers offer companion discounts with many auto insurance companies. Please indicate your auto insurance carrier information:



Check "Yes" if you would like an auto quote with a homeowner policy combination discount. Please also include a copy of your current policy declaration, if possible.
YesNo

Does your home have an alarm system?
YesNo

If yes, is there an outside monitoring service?
YesNo

Does the system monitor for fire and burglary?
YesNo

Do you have instruments, art, cameras, sports equipment, business or other types personal property on or away from the premises, you wish to have covered?
YesNo

Do you have any of the following you want to schedule, to provide better coverage? Jewelry, firearms, gold, pewter, silver, or theft of cash.
YesNo

Do you own snowmobiles or other recreational type vehicles which you wish to cover and are not already? These are not covered under the homeowner's policy.
YesNo

Do you wish to ensure boat(s) or equipment and are not currently insured with a separate boat policy? (The homeowner's policy does not provide liability coverage for most power watercraft and some sailboats)
YesNo

Do you rent any part of your home during the year or any other structure on your residence premises?
YesNo

Do you operate any type of business from your home?
YesNo

Does your home have a fuel oil tank?
YesNo
If yes, where is it located?
UndergroundAbove GroundBasement

Are you interested in flood coverage?
YesNo

Have any additions or alterations been made to your home recently?
YesNo

Do you own any other property (vacation home, rental, etc.)?
YesNo

Do you have a swimming pool?
YesNo

In-ground?
YesNo

Fenced?
YesNo

Would you like information on an umbrella policy?
YesNo

Would you like information on any other form of coverage? YesNo

Privacy Notification

Personal information about you may be collected from persons other than you. Such information as well as other personal and privileged information collected by us or our agents, may in certain circumstances, be disclosed to third parties. You have the right to review your personal information in our files and can request corrections of any inaccuracies. A more detailed description of your rights and our practices is available upon request.

I have read and understood the above privacy notification. I have completed this form in its entirety and certify that the information I have provided is true to the best of my belief.


Typing your name in above field confirms digital acknowledgment of signature.

Our Difference

  • We shop multiple top-rated companies for you
  • We’ll explain coverage to you in a simple way
  • We have a 98% renewal rate
  • 86% of our clients are from referrals
  • We’re here when you need us

Have a question about a new or existing policy?

Just Ask!