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Park Model Home Insurance
Quote Request

(click here for Condo insurance HO-6)      (click here for Renters insurance HO-4)

 

ABOUT THE OWNER

First Name:
Last Name:
Name of Park (if known):
Location Address:
City:
State:
Phone:  
Zip Code:
Birthday:
E-mail:  
Confirm E-mail:  
   
Gender:
Social Sec Num (Not for CA, for accurate quote, otherwise estimate)  
Status Single   Married  Widowed
 

ABOUT YOUR MOBILE HOME / MANUFACTURED HOME

Year Built:    
Size (in sq feet):
Length:   
Width:
   
Community:          
Name of Park:
Manufacturer & Model:
   
How would you describe your home:
   
Stories:  
   
Skirted:
Foundation:
  If you have a permanent foundation, you may qualify for a different type of policy.
Usage:
   
   

COVERAGE OPTIONS

Structure Coverage Requested:  $

(amount needed to rebuild your home - please provide an estimate)

Purchase Price:  $
Liability Limits:  $50k$100k $300k $500k
Extra Personal Property Coverage: $ (optional, beyond the already included portion)
 
Other: Do you have a pet?   If yes, choose amount of animal coverage:
  Prior losses or claims?
  Woodburning Stove?
Seniors:
Construction:   
Roof Type:
Mortgage:
Earthquake Coverage:
Flood Coverage:
   
Extras:
  Is the dwelling within 500 feet of native brush, or isolated or inaccessible to fire fighting equipment?

Yes     No

   
  Do you currently have insurance (if yes, with what carrier? 
  What is your current yearly or monthly premium?
 
Prior Claims #1:
Prior Claims #2:
   
  Do you have any other information about your rental or apartment, or comments that you would like to share? Please place special requests here, such as extra coverage for special items.
 
 

 

Click here for Traditional Mobile Home, Manufactured Home, or Modular Home

 

How to reach us:

We work with different mobile home insurance carriers to help you find the balance of price and coverage that you are seeking.

If you are not sure of exactly what you need, make sure to at least give us a description of your property and we will send you a base quote that we can later adjust to find what is right for you.

 

As an independent insurance agency, we can compare quotes from different insurance carriers to help you find a competitive rate.

Why choose us as your agent?

 

 

 

 

 

 

 

 

STATE NOTES:

ALL STATES: Extended replacement cost quoted where available.  If replacement cost of extended replacement cost is included it the quote, it will be shown on the quote.

OHIO: Mine subsidence coverage will be quoted where available.

TEXAS: Wind and hail coverage will be quoted unless your request that it is excluded.

 

                   

 

     NO COVERAGE IS BOUND, OFFERED, ISSUED THROUGH THIS ELECTRONIC COMMUNICATION, ALL POLICIES MUST BE UNDERWRITTEN AND APPROVED BY THE CARRIER. DO NOT CANCEL YOUR CURRENT INSURANCE. COVERAGE OPTIONS BY STATE, CARRIER, AND/OR PROGRAM.

Copyright 2012 Stratum Insurance Agency, LLC