Mobile Home Insurance Quote Form
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Personal Information
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Mobile Home Information
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Other contact information
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Miles to Nearest Fire station
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Feet to Nearest Fire
Hydrant
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Who will occupy the dwelling:
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1. Is the mobile home owned/titled in business/corporation or for any business use?
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2. Does insured have 2 or more theft/liability losses or more than 3 losses of any kinds in the last 3 years or open/pending claim?
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3. Is there any un-repaired damage from previous claim?
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4.Is the mobile home tied down and fully skirted and accessible to fire fighting equipment?
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5. Is the mobile home currently occupied or will be within 10 days from the inception date unless it is a seasonal risk?
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6. Is home with woodstove as primary source of heat or with a kerosene heater?
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7. Is home located in an area prone to flooding, mudslides, brush/forest fire or within 1500 feet of any waterfront?
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8. Is home located in an area prone to flooding, mudslides, brush/forest fire or within 1500 feet of any waterfront?
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9. Is home on commercial farm property or with extensive farming equipments or used for food vendors, carnivals?
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10. Is home with unattached structures exceeding 800 square feet or 50% of the value of the mobile home or being used as living
area?
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Home Owners Policy: can only be issued when the owner of the property occupies the house
A Fire Dwelling Policy: Will be issued to cover the building structure only (not contents) when house is occupied by other than the Home owner or when
the home owner, occupant of the home elects to do like so.
If you are a tenant looking to cover your contents in the building you are renting you need Renters Insurance
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Or Print and Fax to: 602 200-0063
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