Homeowners Insurance

ANY LOSSES IN THE LAST 5 YEARS?
ESCROWED?
RESIDENCE:
STYLE:
CONSTRUCTION:
SIDING:
BASEMENT:
FINISHED:
FINISHED:
CRAWLSPACE:
SLAB:
BUILT ON PILINGS:
SUMP PUMP:
BACK-UP SYSTEM:
BACK-UP POWER
GARAGE:
TYPE:
FINISH:
FINISH:
FINISH:
EXTERIOR STEPS:
RAILINGS:
FIREPLACE:
WOODSTOVE:
DECK:
OPEN PORCH:
ENCLOSED PORCH:
POOL:
POOL POSITION:
FENCED:
TRAMPOLINE:
HYDRANTS:
OWN ANY PETS?
BITE HISTORY?

UPDATES (PLEASE FILL IN YEAR)

ROOF:

TYPE OF ROOF:
MATERIAL:

PLUMBING:

TYPE OF PIPES:

ELECTRICAL:

CIRCUIT BREAKERS:

HEATING:

TYPE OF HEAT:
HEATING:
CENTRAL AIR:
LOCATION OF OIL TANK:

AGE OF TANK:

TANK COVERAGE:
TANK TESTED:
ALARM SYSTEMS:
CENTRAL STATION ALARM SYSTEM: ((CERTIFICATE REQUIRED))
INDOOR SPRINKLER SYSTEM: ((CERTIFICATE REQUIRED))
ANY BUSINESS IN HOME:
NON-SMOKERS:
ANY SCHEDULED ITEMS:

OTHER INSURANCE COVERAGE

FLOOD:
AUTOMOBILE:
UMBRELLA:
BUSINESS: