| 985-224-1314 AssocIns2006@yahoo.com |
Welcome to:
ASSOCIATES
INSURANCE
NETWORK
ASSOCIATES
INSURANCE
NETWORK
Quote Property
Information of Interest
Use this space to expand on one of the information links you provided above. You might consider
highlighting a new area each week, or providing a calendar of company or local events.
highlighting a new area each week, or providing a calendar of company or local events.
Click Here for Places To Go and See in the Bay Area
Contact Information
850 Sir Francis Drake Blvd. San Anselmo, CA 9496
sally@abcrealty.com 415.888.1625
Use this area to provide more
information for your potential
customers. You can keep
customers coming back by
updating this section regularly.
information for your potential
customers. You can keep
customers coming back by
updating this section regularly.
City Information: Links to government and information pages for the cities I serve.
Local schools: School districts in the cities I serve.
Local news: Local news services.
Regional Information: Information on the Bay Area.
Local transportation: Bay Area transportation links.
Local schools: School districts in the cities I serve.
Local news: Local news services.
Regional Information: Information on the Bay Area.
Local transportation: Bay Area transportation links.
Sausilito, California
 |
 |
 |
 |
 |
 |
 |
| Print - Complete - Fax for Property Quote Associates Insurance Network, LLC Email AssocIns2006@yahoo.com Today's Date ____/____/_______ Phone 985-224-1314 Fax 985-224-4145 Renewal Date ____/____/_______ Referred by __________________Phone # ________________ Fax# ____________ Insured 1: _______________________ BDay: ___/___/_____ M / F:__ SS#____-____-______ Insured 2: _______________________ BDay: ___/___/_____ M / F:__ SS# ____-____-______ Current Address: _________________________ City: _______________ Zip Code_________ New Address: ____________________________ City: _______________ Zip Code_________ Phone: _(_____)________________ Cell/Work: _(_____)_____________ Ext. _____________ ************************Please complete form and e-mail appraisal if available**************************** Current Co.: ______________ Premium: $______ Deductible:$_____ Cosing/Renewal Date___/___ Homeowners/Condo/Townhouse/Rental/Renters:________________ Is the Property Vacant? ____ Home Value:$_______ Loan Amt:$_______ Living Sq Ft:_______ # Bedrooms:__ #Baths:___ Pool?__ Yr.Built:_____ Construction Type?__________ Piers/Slab:______ Central Air/Heat?____ # Stories ___ Fireplace?#___ Garage/Carport?___________ # Cars:___ Attached/Detached:__________________ Bankruptcy in 5 Yrs?______ Roof Type?__________ Yr Roof Replaced?_______ Dogs/Breed?______ SmokeDet/DeadBolts/FireExt?_______ Monitored or Local Alarm?_________ First Time Buyer__? Any Losses in 5 yrs?_____ Date:____/____/_____ Type:__________ Amount:$__________ Flood Insurance? _____ Have Elevation Certificate?_____ Special coverage needs?____ Amt?______ Interested in Mortgage Protection/Life Insurance? _____ Interested in saving up to 15% on Homeowners Insurance by insuring your Home and Auto?____ "To provide an accurate quotation we need to request a few reports that verify prior losses and insurance scores. This is the reason we request the SS# on all Insureds. |