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Insuring Minnesota
20960 Holyoke Ave
Lakeville, MN 55044
Phone: 952-469-0425
Fax: 952-469-1881

E-Mail us at:
info@insuring
minnesota.com

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Minnesota Insurance License #44761

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Low Cost Minneapolis Fire and Rental Property Insurance Rates! FREE
QUOTES!
 
Minneapolis Dwelling Fire & Rental
Property Insurance Quote Form
One Simple Form - takes only 2-3 Minutes!


Your Personal Data:
 
Your Name:
Property Address:
City:
State: MUST be Minnesota!
Zip/Postal:
E-Mail (REQUIRED):
E-Mail
(again for accuracy):
Phone:
Fax (optional):
 
What is the Primary Policy Holder's Social Security Number?
(Some carriers use credit history for rating, this information is REQUIRED)
 
Dwelling Information
 
Year Home Built:
Home Square footage:
 
Number of units: 1 family Duplex
Triplex Four Units
 
Occupancy: Apartments
Tenant Occupied Home/Duplex
 
Type foundation: Slab Crawlspace over slab
Concrete Block Other (list in remarks)
 
Type Roof: Shingle Wood Shake
Tar/Gravel Spanish Tile
Metal Other
 
Number of stories: One 1.5
Two Three
 
Allow Animals or Pets? Yes No
If yes, list type/for dogs, list breed:
 
Do You Allow Trampolines? Yes No
 
# of feet to nearest
fire hydrant:
# of miles to nearest
fire station:
 
Currently Insured? Yes No
Name of Carrier & how long insured?
 
Prior Claims? Yes No
Describe claims in detail:
 
Plumbing type: Copper Galvanized
Mixed (Copper/Galvanized)
 
Circuit Breakers or fuses? Breakers Fuses

# Bedrooms: # Bathrooms:
 
# Fireplaces: # Chimneys:
 
Special features
(i.e., deck, air conditioning, alarm systems, pool, etc.)
 
Coverages:
 
Dwelling Cov. $ Contents $
Liability Cov. $ Deductible $
($250, $500, $1,000, etc.)
 
Comments/Remarks
(describe any scheduled jewelry, in-home business, or other special coverages needed here):
 
Send my quotation via: E-Mail Fax
Regular Mail
Call Me by Phone

Thank you for filling out this form COMPLETELY!

We value your input as PRIVATE information. Every step has been taken to insure your privacy, security, and our intent is to release quote information only to you. We will not give your data to ANY other person or group for sales, marketing, or ANY other purposes. By checking the box below you agree to allow our agency to release this information via the method you have chosen, and to release us from any liability should this information be accidentally viewed by others. Our intention is to maintain your complete privacy.

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