Agent Quote - Home / Landlord / Condo

Thank you for letting us assist with your property insurance! Please complete the information below, to the best of your ability. As you may know, we partner with a handful of insurance companies and will present the quote with the best rate and coverage recommendations. Our goal is to have a QUOTE TO YOU BY THE END OF THE NEXT BUSINESS DAY.

Named Insured / Legal Name of the Owner(Required)
Please the name as it will appear on the loan or deed. If there are any other Legal Owners, LLCs, Trusts, please list them in the comments section below.
Diploma, some college, Vocational/Technical Degree, Associates, Bachelors, Masters, PHD, Medical or Law Degree
MM slash DD slash YYYY
Property Address (property being quoted)(Required)
Style of Home(Required)
Occupancy Status(Required)
What year was the roof added or replaced?
Max. file size: 98 MB.
If the roof is in good condition, we don't always need these for the quote. However, the insurance company may require them before issuing the policy.
Primary Heating(Required)
Secondary Heating
If applicable.
Air Conditioning(Required)
Please describe what form of AC & if it has the same or separate duct work. Central AC, Heat Pump, Window Units
Foundation Type(Required)
Siding Material(Required)
Please describe if it's a standard lot size, or the # of acres if it's on land.
Is there a Trampoline on premises?(Required)
Some insurance companies restrict trampolines, so knowing this will help us quote correctly.
Is there a Pool on premises?(Required)
Please let us know if there is a pool. In the comments, please include whether it's inground/above ground and fenced.
Are there any dogs in the household?(Required)
Some insurance companies restrict certain dog breeds, so knowing this will help us quote correctly.
Please describe the dog breed.
This is a unique question, but some insurance companies ask us to include this information.
Is your home located in an area governed by a homeowner's association?(Required)
If your property is part of a homeowner's or property association, there are additional coverage options to review.
Do you conduct business in your home?(Required)
If you have clients coming to your home, have business equipment or want to discuss this in more detail, please note YES and add details in the Notes section.
Specific Personal Property(Required)
In many cases there are "sub-limits" for specific property (some examples here). If you want to discuss the limits and options for expanding those limits, please mark the item.
Mortgage & Escrow
Does the home have a mortgage?
Please let us know how you were referred to our team.
Please share who is filling out this form?
If you prefer the quote is sent to you via email or text, please provide that information. If you prefer a phone call, please share the phone number and best time of day for a phone call.
Please include the Agent's Email Address that this form will be submitted to: *Alex@northtowninsurance.com *Aaron@northtowninsurance.com *Joey@northtowninsurance.com
Call or Text Email Claims Payments