Auburn Hills Homeowners Insurance Quotes

If you would like to receive a quote for homeowners Insurance in Auburn Hills, simply fill out the form below and submit. Our helpful agent will contact you for your social security number and we will prepare your quote promptly.

Please contact our office if you have any questions about homeowners insurance in Auburn Hills.

Personal Lines Home Questionnaire

Applicant Name

Date of Birth

Phone Number

Ext

Co-Applicant's Name

Date of Birth

Phone Number

Ext

Mailing Address

Street Address

City/State

Postal/zip Code

Property Address (if different from mailing)

Street Address

City/State

Postal/zip Code

Date of Occupancy (mm/yyyy)

Feet to Hydrant

Miles to fire Station

Township (if not in City Limits)

Present Carrier

Number of years with Carrier

Expiration Date

Form

Dwelling (HO-3)Renters (HO-4)Condo (HO-6)

Rental Dwelling

YesNo

Rental Dwelling

DwellingHO6

Seasonal or Secondary

YesNo

Seasonal or Secondary

HO3HO4HO6

Mortgage Free?

YesNo

Premium Paid by

EscrowInsured

Payment Plan

Indicate Current Limits

Coverage A - Building

Coverage B - Other Structures

Coverage C - Contents

Coverage D - Loss of Use

Coverage E - Liability

Coverage F - Medical Payments to Others

Deductible

Market Value or Purchase Price if recently purchased

Year Built

Number of Families

Total Square Footage

Exterior Wall Material

% of Brick
% other than Brick

Miscellaneous Information

Are all household residents Non-Smokers?

YesNo

Alarm System?

YesNo

If YES to Alarm

CentralPoliceCentral

Central Alarm Monitoring Company Name

Smoke Detectors?

YesNo

Fire Extinguisher?

YesNo

Dead Bolt Locks? (on every exterior door)

YesNo

Sump Pump?

YesNo

Swimming Pool?

YesNo

Wood Stove?

YesNo

If YES select all that apply

Above GroundBelow GroundDiving BoardSlide

Fence for Pool?

YesNo

Fence Height

Fence Locked?

YesNo

In Home Business?

YesNo

If yes, type of business:

Trampoline?

YesNo

Trampoline Netted?

YesNo

Fenced Yard?

YesNo

Hot Tub?

YesNo

Hot Tub Locked Cover?

YesNo

Dogs?

YesNo

How Many Dogs?

Breed(s)

Bite History?

YesNo

If yes, please explain

What Year Were the Following Systems Updated?

Plumbing
Electrical
Heating
Roof

Any Claims in the last 5 years?

YesNo

If YES, please describe claims:

Type	Amount Paid Out	Details
Claim 1:	Claim 1:	Claim 1:
Claim 2:	Claim 2:	Claim 2:
Claim 3:	Claim 3:	Claim 3:
Claim 4:	Claim 4:	Claim 4:

Scheduled Personal Property

# of Items	Total Value
Jewelry:	Jewelry:
Furs:	Furs:
Fine Arts:	Fine Arts:

Group Discount

Name	Membership Number
Professional Society:	Professional Society:
Senior Association:	Senior Association:
Alumni-College/University :	Alumni-College/University :
Bank or Credit Union :	Bank or Credit Union :
Other Affiliations/Societies:	Other Affiliations/Societies:

Do you want a life quote?

YesNo

Notes to Agent

By submitting your information, you agree to the following terms:

Insurance Coverage cannot be bound or changed via submission of this online form/application, e-mail, voice mail or facsimile. No binder, insurance policy, change, addition, and/or deletion to insurance coverage goes into effect unless and until confirmed directly with a licensed agent and or your insurance company.

Note any proposal of insurance we may present to you will be based upon the values developed and exposures to loss disclosed to us on this online form/application and/or in communications with us. A proposal is not an insurance policy. Please refer to the actual policy for coverage limits, definitions and coverage exclusions.