Just answer a few simple questions and we will contact you shortly with a homeowners quote.  If you would prefer to talk to an agent, just call us at (585) 798-2530.

Last Name *

First Name *

Middle Name

Occupation *

Street Address i.e. (411 Main St Medina NY 14103)

Address of Property to be Quoted (specify if same as above) *

Phone Number

Email Address

Date of Birth

Current Insurance Company (if property already insured)

Amount of Insurance Requested on Dwelling (optional)

Owner Occupied? *

1 or 2 family house? *

Fire Hydrants within 1,000 feet? *

Year Built?

Has any work been done to the house in the past 20 years, if so what? *

What is the construction of the house? i.e. frame/masonry

Is this a seasonal dwelling, or is it your full time residence? *

Any supplemental heating such as a wood stove? *

Do you have any valuable items that you may need special coverage for? (examples may include jewelry or antiques) *

Do you have a home business? *

Do you have any animals, if so what type or breed? *

Do you have a trampoline? *

Do you have a swimming pool? *

List all previous homeowners claims including the date: *

Do you have smoke detectors, a fire extinguisher, dead bolt locks, or an alarm system of any type? *

Are you being canceled by your current carrier for any reason? *

Is there any more information you might have that would assist us in providing you with a more accurate quote?