Home Quote — San Diego General Insurance
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Contact
Request Evidence of Insurance
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San Diego General Insurance
Info
Contact
Request Evidence of Insurance
Make Changes To Your Policy
Get a Quote
Home Quote Questionnaire
Names of Household Members
*
First Name
Last Name
Birthdate
First Name
Last Name
Birthdate
Email Address
*
Is the property in the name of a trust?
Yes
No
Primary Phone
(###)
###
####
Address
*
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Purchase date
Year Built
Square Feet
Type of Roof
Shake
Tile
Asphalt
Rock
Other
Year roof was replaced
Year plumbing was replaced
Year furnace was replaced
Year electrical panel was replaced
Stories
1
2
3
4
Garage
1 car
2 car
3 car
4 car
5+
Is the garage attached?
Yes
No
Full Baths
1
2
3
4
Half Baths
0
1
2
3
4
Fireplace(s)
0
1
2
3
4
Pool
Yes, fenced
Yes, unfenced
No
If there is a pool, does it have...
Diving board
Slide
Both
None
Jacuzzi
Yes
No
Is there a dog at the property?
Yes
No
If yes, what breed?
If yes, is there a biting history?
Does the property have indoor sprinklers?
Yes
No
Number of solar panels
Any Claims on any property in the past 5 years?
Yes
No
Date, type of claim, and amount paid for each claim
Is there a trampoline on the property?
Yes
No
Is there a skateboard ramp on the property?
Yes
No
Is there a bicycle jump on the property?
Yes
No
Does the home have an automatic water shutoff valve?
Yes
No
Does the home have a monitored fire and burglar alarm?
Yes
No
Current Insurance Company
Renewal date of current policy
Do you want to include earthquake coverage?
Yes
No
Referred By
Any Additional Comments
Thank you!