Saturday, July 5th 2008  
 
   
About Us
 
 
 
Personnel
  
 
 
   
   
   

440.255.6500 Mentor
800.659.2732 Toll Free
440.974.2230 Fax

 

 

  
 
 
 
Slowey-Krueger Online Quote
 
 
Home Owner/RentalProperties/Condominium/Renters
  
 


 
 
Name
  
 
e-mail
  
 
Phone
  
 
Address
  
 
City
  
 
State
  
 
Zip
  
 
  Renewal Date
  Current Insurance Company
  Other
 
  Current Coverages
 
  Coverage "A" Dwellings $
  Coverage "B" Other Structures $
  Coverage "C" Contents $
  Coverage "D" Loss of Use $
  Coverage "E" Liability $
  Coverage "F" Medical Payments $
  Deductible $
 
  Jewelry or other Scheduled?
  If yes list:
 
 
  Water back up of sewers/Drains?
 
$
  
 
  Earthquake?
  Deductible $
 

Other endorsements or coverages
Explain Below ...
 
  Losses in last 5 years amount paid
 
 
 
 
 
 
 
 
  Homeowner/Dwelling Information    
 
  Construction  
  Year Built  
  Square Feet  
  # of Stories  
  Baths  
  Bedrooms  
  Fire Place  
  Hearths  
  Chimneys  
  Wood Stove  
  Swimming Pool  
  Fenced  
  Alarm System  
  Basement  
  Basement Type  
 
  Garage Stalls  
  Outbuildings Sq Ft  
  Construction  
 
  UPDATES
 
  Plumbing (year)  
  Electrical (year)  
  Heating (year)  
  Roof (year)  
  Exterior (year)  
 
  Complete if Rental Property
 
  Occupancy  
  Dwelling Type  
 
  Where did you hear about Slowey-Krueger?
 
  Please include any other questions you may have....
 
 

 

 

  
     
     
 
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