Landlord Insurance in Pasadena | Landlord Insurance Pasadena | Landlord Insurance Pasadena | Landlord Insurance Pasadena Ca


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Steve

Stephen B. Groton -- Insurance Agent and Broker - Get a Landlord Insurance Quote
CA License Number 0816642
626-584-6303

Landlord Insurance
Rental Property
Free Quotation Form
One Simple Form - takes only a few minutes!

Your Personal Data:

Your Name:

Property Address:

City:

State: (Must be California)

Zip/Postal:

E-Mail (REQUIRED):

Phone:

Fax (optional):

Dwelling Information

Year Built:

Dwelling square footage:

Number of units: 1 family Duplex Triplex

Type foundation: Slab Crawlspace
Basement Other (list in remarks)

Type Roof: Shingle Wood Shake
Tar/Gravel Metal
Tile Other

Number of stories: One 1.5
Two Three

Do you allow animals or pets? Yes No

If yes, list type/for dogs, list breed:

Are You Near Brush Area? Yes No

# of feet to nearest
fire hydrant: # of miles to nearest
fire station:

Plumbing type: Copper Galvanized
Mixed (Copper/Galvanized)
PVC

Circuit Breakers or fuses? Breakers Fuses

Currently Insured? Yes No

How is Your Credit History?
(Some carriers use credit history to qualify)

Prior Claims? Yes No

Describe claims in detail:

# Bedrooms:		# Bathrooms:

# Fireplaces:		# Chimneys:

Special features (i.e., deck, air conditioning, alarm systems, pool, etc.)

Coverages:

Dwelling Cov. $		Contents $
Liability Cov. $		Deductible $ ($250, $500, $1,000, etc.)

Comments/Remarks (describe any scheduled jewelry, in-home business, or other special coverages needed here):

Send my quotation via:		E-Mail Fax Regular Mail Call Me By Phone

Thank you for filling out this form COMPLETELY!

We respect your privacy! Every step has been taken to insure your privacy and security. It is our intent to release quote information only to you. We will not give your data to ANY other person, company, or group for sales, marketing, or ANY other purposes. By checking the box below you agree to allow our agency to release this information via the method you have chosen, and to release us from any liability should this information be accidentally viewed by others.

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