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Landlord Insurance Quote

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The state where you need insurance coverage*
Unfortunately, we are only licensed to provide insurance in California, Oregon and Washington states.
Name*
First Last
Email*
Phone*
Address*
Street Address Address Line 2 City State Zip Code
Same as Mailing Address?*
- Yes
- No
Mailing Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Date of Birth*
MM slash DD slash YYYY
Occupation*
What is your marital status?*
- Married
- Widowed
- Separated
- Divorced
- Single
Spouse's Name*
First Last
Spouse's Email*
Spouse's Phone*
Spouse's Date of Birth*
MM slash DD slash YYYY
Spouse's Occupation*
Are you a member of a Mennonite Church?*
- Yes
- No
Name of church where you are a member*
Losses in Five Years*
- Yes
- No
Please Explain*

Type of Cooling*
- Central
- Evaporative
- Other
Type of Heating*
- Central
- Wall Furnace
- Floor Furnace
- Wood Stove
- Other
How many wood stoves?
Is this your Primary Heat Source?*
- Yes
- No
Smoke Detectors?*
- Yes
- No
Are there animals on the property?*
- Yes
- No
What kinds of animals and how many?
If there are dogs, what breeds?
Have any of your animals injured someone?*
- Yes
- No
Any Business on Premise?*
- Yes
- No
What kind of business?
Some common examples are: farming, piano lessons, home day care, product sales, repairs, arts & crafts, consulting, home maintenance or cleaning, food preparation and sales, tutoring or teaching, and animal boarding.
Distance to Fire Hydrant*
- Over 1,000 feet
- Less than 1,000 feet
Distance to Fire Department*
- Over 5 Miles
- Less than 5 Miles
Detached Structures?*
- Yes
- No
Describe the structure
Solar Panels?*
- Yes
- No
Do you currently have homeowners insurance?*
- Yes
- No
If home built prior to 1960, have Plumbing and Electrical been upgraded?*
- Yes
- No
Please Explain
Finishing Comments
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Name
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PO Box 878
1110 J St., Reedley, Ca 93654
559.638.2327
mennonite@mennoniteinsurance.com

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