Home Quote Machine - Albano Agency

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1CONTACT

2DWELLING

3HISTORY

4SPECS

5UTILITIES

6FINISH

Primary Named Insured *

First

Middle

Last

Primary Named Insured's Date of Birth

Phone *

By providing your phone number, you agree to receive text messages and/or calls for information and marketing purposes. You can opt out at any time.

Email *

Marital Status *

If married, spouse information will be required.

Would you like to add a Co-Applicant? *

All deeded owners should be listed.

Second Named Insured / Spouse *

First

Middle

Last

Second Named Insured's Date of Birth

Relationship to Insured *

Home Address *

Address Line 1

Address Line 2

City

State

Zip Code

Have you resided at this address for less than 3 years? *

Prior Residential Address *

Address Line 1

Address Line 2

City

State

Zip Code

Do you have a separate mailing address? *

Mailing Address *

Address Line 1

Address Line 2

City

State

Zip Code

Is your home a pending new purchase? *

When did you purchase your home?

When is your expected closing date?

What year was your home built? *

Is your home currently insured? *

Have your insurance documents with you? *

Upload your Declarations Page *

Click or drag a file to this area to upload.

Your declarations page will contain all coverages such as dwelling, liability and scheduled items. This valuable step ensures an accurate quote, matching up all your existing coverages so you can truly compare the price apples to apples.

Who is your current insurance carrier? *

What is the expiration date? *

Must be exact, can be found on letters, insurance docs or possibly email history.

Who was your prior insurance carrier? *

Have you submitted any homeowner's insurance claim(s) in the last 5 years? *

Describe each claim. Provide the approximate date of loss and total payout amount for each. *

Do you have any dogs on premises? *

Have any dogs on the premises ever bitten anyone? *

Living square footage (excluding basement) *

Include square footage for all finished and heated living spaces from ground level and above. Do not include basement below grade.

Select # of Bedrooms

1 Bedrooms

Select # of Full Bathrooms

1 Bathrooms

With Showering Facilities

Select # of Half Bathrooms

0 Bathrooms

Without Showering Facilities

Exterior Material *

Brick
Vinyl
Wood Shakes
Wood Cladding
Fiber Cement (Hardie Board)
Stone (Masonry)
Faux Stone
Stucco
Other

If there is a mix of materials, check all that apply.

Roofing Material *

Roofing Material | Other *

What year was your roof last replaced? *

Basement Height *

Full
Partial
Crawl Space
Slab - No Basement

Basement Material *

Concrete Block
Poured Concrete
Stone
Pre-Fab/ Precast (Superior Walls, ICF, etc.)
Other

Basement Material | Other *

Please list the basement material type.

Basement Entry/Exit *

Walkout (Ground Level)
Interior Stairwell
Outdoor Stairwell
Storm Door
Floor Hatch
Other

Check all that apply.

Basement Entry/Exit | Other *

Please list all the entry/exit points for basement.

What percent of the basement is finished? (0-100%)

0% Finished

Primary Heating Source

Primary Heating Fuel Source

Primary Heating Fuel Source | Other *

Please describe the primary heating source for your home.

Oil Tank Location *

Homes with an underground oil tank are ineligible for a homeowners quote.

Is there an underground oil tank on the property? (under the soil)

Air Conditioning Type

Secondary Heating Source *

Select an alternate heating sources in your home *

Pellet Stove
Wood Burning Stove
Gas Fireplace/Insert
Wood Fireplace
Other
None

Check all that apply.

Alternate Heating Source | Other *

Please describe the alternate heating source for your home.

Select # of fireplaces in total

1 Fireplaces

Electric | Year Updated/Renovated *

Estimate when the utility was last fully updated/renovated. Mark N/A if original or unknown.

Plumbing | Year Updated/Renovated *

Estimate when the utility was last fully updated/renovated. Mark N/A if original or unknown.

Heating System | Year Updated/Renovated *

Estimate when the utility was last fully updated/renovated. Mark N/A if original or unknown.

Do you have a Garage? *

Garage Type

Is there a Front Porch/Stoop? *

Front Porch/Stoop SQFT

Hint: Length x Width = SQFT

Front Porch/Stoop Finishing Material *

Wood
Composite (Trex)
Stone
Concrete
Other

Is there a Back/Side Deck? *

Back/Side Deck SQFT

Hint: Length x Width = SQFT

Back/Side Deck Finishing Material *

Wood
Composite (Trex)
Stone
Concrete
Other

Do you have a Pool? *

Pool Type *

Pool Safety Features *

Fully Fenced-In
Partially Fenced-In
Self Closing & Latching Gate
Lockable Gate
Removable Stairs
Pool Alarm

Check all that apply.

Do you have a Hot Tub? *

Is the Hot Tub physically attached to your home? *

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