Personal Lines
Homeowner 25K -250K
Homeowner 250K +
Dwelling Fire
 
Additional Resources
Guidelines
Procedures
Premium Finance
ACORD Application
E&O Professional Liability
 
HOMEOWNER   $ 250,001 and up
 General Information
  Date    
Agency Phone
  
  Agency Name    
Agent's Fax
    *
  Agent Contact    
Agent's Email
 
 Insured Information
  Insured Name    
 
  Insured's Occupation    
 
Number of Mortgages  : 1  2  3
 Risk / Property Info
  Risk Address    
Zip Code
  
  City    
County
  
  Square Feet     
Roof Type
  
  Year Built      
  Residence   
Primary Secondary Tenant Occupied
  ConstructionType   
Brick Brick Veneer Frame Stucco  
  If home is 10 years old or older: Has there been a major renovation to (give the year):
 
 Wiring: Plumbing: Heating: Roof:
 
House On 10 Acres or More?    
  Foundation   
Pier & Beam Slab  
   
  Number of Stories :     1,    2,    3,    4    
  Level of Coverage
HO-A - Basic : ACV
HO-A + Water Coverage (Extended Coverage): ACV
HO-A Plus (RCV)
HO-B
Dwelling Fire
 Values and Coverages
  Dwelling Value   $  *  
Other Structures
   $
  Contents Coverage       $  
Additional Living
  $
  Personal Liability   
$100,000 $200,000  $300,000 $500,000
  Medical Payment   
$2,000 $5,000
   
  Deductibles  
Wind/Hail:   Other Perils: 
 Endorsements
   Glass HO-105    RCV Contents HO-101    
 Credits / Deductions
 
Any claims on dwelling or insured in the past 3 years : Yes       No
   (If yes, we need date, type of claim, and amount paid by insurance company)
 
  

 Protection Factors
  Security Systems   
i) Fire/Central Station ii) Burglar/Central Station
     
iii) Smoke Detectors iv) None
  Inside City Limits?  
Yes   No
       
  < 5 mile Fire Station?  
Yes   No
       
  < 1000' to Hydrant?  
 Yes   No
       
  Responding F.D.?  
Yes   No
 
Protection Class
  
  Pool   
Yes   No
       
  Diving Board    
Yes   No
       
  Slide   
Yes   No
       
  Fenced 4 ft (+)   
Yes    No
       
  Additional Coverages : 
 Additional Coverages
You can choose limits (where applicable) from the drop downs to the right
   Water Backup: You can choose limits from the dropdown:    
   Mold: (Subject to NO previous Mold or Water Damage):    
   ID Fraud: (Only 1 limit offered):    
   HO-110 Increased Limits On Jewerly, Watches and Furs:    
   HO-225 Additional Premises Liability:    
   HO-111 Additional Limits on Business Personal Property:    
  Gated Community    
Yes   No
       
 Final Notes and Instructions
  Competing Premium    $    
  Effective Date          
  General Comments  
     
 
   
  This is NOT an Automatic Rater.
Click *Send To Turner For Quote* and both YOU and TURNER will
receive an Email Request To Quote This Property.
Turner will fax you back a Quote, so ensure your fax number is correct (above)
  Turner General Agency, Inc.
Phone: (888) 443.7932 ~ (972) 290.7200		 Fax: (972) 203.8206 Email: Brett Turner at 
brett@turnercompanies.com  		 

 


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