quickquote

MKNI Insurance Services Inc.

Property Quick Quote


Person requesting quote
Email address
Phone number
Name of Your Company (As we provide service to your company, we will add your company name to the list.)
Escrow Office	Real Estate Office		Mortgage Lender

Client's Information
First Name		Last Name
Address1
Address2
City		State Zip
Home Telephone		Email Address
If living at current address for less than three years, please complete this section.

Address1
Address2
City		State Zip
Mortgage Information
Mortgage Company Name
Mortgage Company Address
City		State Zip
Loan Number
Do you currently have homeowners insurance?		What is the expiration date of your current Homeowners Insurance Policy?
Do you own or rent?
Address of Property to be Covered
Address
City		State Zip
Coverage Amount or Limit of Liability Requested
Type of building		Other structures (detached garages for example)
Value of building		Square feet of building
Personal property or contents		Number of units
Liability Limit		Medical Payments
Deductible for property coverages		Fire protection sprinkler system
Construction Type:		Year Built?
Market Value		Distance to nearest fire hydrant in feet
Distance to nearest fire station		Do you have smoke detectors?
Do you have burglar alarms?		Gated Commiunty
Remarks or Additional Information

Is any business conducted within this home?
Has any coverage been declined, cancelled or non-renewed during the last 3 years?

If You Rent, Answer the Following Questions
What is the replacement cost value of your personal items?		What deductible would you prefer for your rental policy?
What are your Personal Liability limits for your rental policy?

Agent name
Agent name