ZOLOFRA INSURANCE AGENCY

Ready to protect you today for what matters tomorrow.

Homeowners Form

CHECK OUT OUR NEW AND IMPROVED WEBSITE AT:

WWW.ALLPROCOVERAGE.COM

 

*Identify the type of features and systems you have in your home:
Local Alarm (Fire and Burglar)
Central Fire
Central Burglar
Sprinklers
Gated Community
Temperature Monitoring
Back-up Generator
Smoke/Fire
Fire Extinguishers
Dead Bolts
Visible to neighbors
None of the above
*Do you also have any of the following? (check all that apply)
*The inside walls of this property contain:
paint
wallpaper
ceramic tile
marble/granite
paneling
*The floors of this property contain:
wood
parquet
ceramic tile
marble/granite
carpet
*Basement
None, on a slab
Finished
Unfinished
Partially finished
Partial basement
*Type of heat:
Above ground oil tank
Below ground oil tank
Electric
Gas
Wood stove
*Regarding your exterior, please check all that apply:
Above ground pool
Inground pool
Pool has a slide
Pool has a diving board
Pool is fenced
Trampoline(s) on premises
If required, I am willing to remove the trampoline(s) within 30 days
None of the above







Do you also own any of the following? (check all that apply)
Minibikes
Mopeds
Motorcycles
Motorhomes
Aircraft
Snowmobiles
Golfcarts
None of the above


 

* indicates a required field.

Disclaimer Notice - The premiums quoted are estimates based on information you provided. This quotation does not constitute a contract of insurance, nor does it provide coverage for any loss or claim. Coverage can only be bound by an agent with a signed application and a down payment.

Please utilize the "Submit" Button to send your form to our office.  If the website does not allow you to submit the form, please print the page and fax it to 732.334.0405 or scan it into your computer and send it to ben@zolofrainsurance.com.  Do not "Refresh" the page because all data entered onto the form will be lost.