Homeowner’s Insurance Quote – AIA Insurance Agents

Dwelling Information

Year Built:

Total Square Feet:

Year Updated:

Wiring: Plumbing: Roof: Heating:

Earthquake Retrofitted:

Bolted to Foundation?:

Y N

Cripple Walls?:

Y N

Water Heater Strapped to Structure?:

Y N

# of Stories:

Construction:

Foundation:

Roof Material:

Garage - # of Cars:

Garage Type:

# of Bedrooms:

# of Bathrooms:

Other Rooms:

Den Family Room Kitchen Nook

# of Fireplaces:

Hearths: Chimneys:

Type of Heating:

Central Wall Furnace Gas Electric

Central Air:

Y N

Ducts:

Screened Patios:

Square Feet:

Breezeways:

Square Feet:

Porches:

Square Feet:

Balconey / Deck?:

Y N

Square Feet:

Finished Attic?:

Y N

Square Feet:

Finished Basement?:

Y N

Square Feet:

Walkout Basement?:

Y N

Square Feet:

Woodburning Stove?:

Y N

Outdoor:

Pool w/Diving Board Fenced In Spa Jacuzzi

Class of Construction:

Condition:

Feet to Nearest
Fire Hydrant:

Miles to Nearest
Fire Dept.:

Pets?:

Y N

Biting History:

Y N

Fire/Security:

Dead Bolt Locks Fire Extinguisher Smoke Detectors
Security Alarm (Monitored) Security Alarm (Not Monitored)
Fire Alarm (Monitored) Fire Alarm (Not Monitored)