Sumners Insurance and Real Estate

114 North Main Street
PO Box 188
Clarion, IA 50525

Phone: 515-532-6653 or
1-800-778-9310
Fax: 515-532-6920

Sumners Homeowners Insurance Quote

Please fill out the information below and click "submit". If you make a mistake click "reset".

General Information

Name:
Address:
City:	State: ZIP:
County:	Email:
Phone Day:	( ) - Night: ( ) -
Best time to call:	am pm
Occupation:	How long at current job: years months

Current Homeowners Insurance Company (not agency):

Company Name:
Policy Exp. Date:	/ /
Amount Insured For:	$
Premium:	$
Term:	6 Months 1 Year Other

Home Information

How long at present address:	years months	# of claims in last 3 years:

Sq. footage of home (excluding garage and basement):		Year home was built:

Structure Information

Type:	Construction:	Roof:	Foundation:	Garage:

		Age of roof: yrs.

Features

Bathrooms:	Basement:	Deck/Porch/Patio:	Fireplaces:
# of Full: # of Half:	Sq. Ft:	Deck Sq. Ft: Porch Sq. Ft: Screened Patio Sq. Ft:	# of Chimneys: # of Hearths:

Additional Features

Heating System:	Central Air:	Central Vac:	Security Alarm:	Fire Alarm:	Smoke Detector:
	yes no	yes no			yes no

Coverages
Personal Liability	Medical Payments	Deductible	Is this your primary residence?
			Yes No

Comments:

PLEASE NOTE: These insurance quote's are estimates and although depict a fairly accurate figure, do not represent the true cost. Because of the many attributes that determine price and coverage an exact figure can only be given after completing a full application.