Home Insurance Quote... Name Address City State Zip Phone Number Fax Number E-Mail Age or Date of birth Address of Home Year Built Exterior Construction material of house (ie. Brick, frame, vinyl siding etc) Alarm System ? Yes No If so is it monitored. Yes No Closest responding fire department How far is fire dept. How close to fire hydrant Coverage Amount on dwelling Coverage amount on Content Liability limit Deductible Any specific endorsements? I.e., glass coverage, jewelry, satellite dish, etc. Any claims last 3 years Yes No If so please list what type of claim?