Winning Home Quote "*" indicates required fields Thank you so much for calling today about protecting your home. I will need to gather information to get you the best price and the best coverage. Is it okay to ask you the questions needed to provide you with our White Glove Insurance Service?What is the address of the property you want to get insurance for?* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Is this home a new purchase?* Yes No What is the name of your current home insurance company and when does it expire?*To give you the most accurate quote, I’ll need a copy of your current coverages and deductibles. You can text or email it or I have a quick link that can save us about 30 minutes today—I can text or email it to you right now. Just enter your insurance company name, log in, and it’ll send me everything I need to provide you with the best insurance at the best price. Super easy for both of us! Want me to send it over? If your home insurance is being canceled or nonrenewed, I’ll also need a copy of the cancellation notice.What is your best phone number?*What is your email?* What is your name?* First Last Is this the name the home is deeded to?* Yes No Deeded Owner(s) NameWhat is your date of birth?* MM slash DD slash YYYY Are you married or single? Married Single What is your occupation?Is there anyone else's name listed on the deed?* Yes No What is their name? First Last What is their date of birth? MM slash DD slash YYYY What is their occupation?Do you live in this home, rent it out, or something else?* Owner Occupied Rental Vacant Builders Risk What is your mailing address?If you've lived here less than 5 years, what is your prior address?Is any part of the home a mobile or modular home? Yes No Is risk a new ground up construction or a major renovation? Yes No What is the purchase price of the home?How much is the cost of repairs?How many months of insurance do you want?Describe the renovations to be doneWhat building limit would you like quoted?Is it an annual lease or a short-term vacation rental? Annual lease Short-term vacation rental Do you require your tenants to have a rental policy? Yes No Do you have a property manager? Yes No Do you have a pool or trampoline?* swimming pool trampoline none Does the pool have a diving board or slide? diving board slide that goes into the pool none Do you have any preference for coverages or deductibles?* Yes No List preferencesAre there any pets?* Yes No What is the breed type? Mixed breed is an unacceptable answerDoes your neighborhood have a guard, a gate or is it a single-entry neighborhood?* Yes No Does your home have a monitored home alarm?* Yes No In the last 5 years have you had a bankruptcy, foreclosure or repossession?* Bankruptcy Foreclosure Repossession None Provide detailsIs it still open? When did it close? Why did it occur?Have you had any home insurance claims in the past 5 years?* Yes No Description of claim (fire, liability, hurricane....)What is the date of claim(s)How much was paid?Is the claim opened or closed Open Closed What year was the home built?*How old is your roof?What type of roof do you have? 3-tab shingle architectural shingle metal flat something else How old is your water heater?What type of plumbing do you have? PVC Galvanized Polybutylene How old is your central heat and air system?Other than price, is there anything you don't like about your current insurance?*What is the best way to provide you with the proposal, a phone call, email, or text?* Phone Call Email Text How did you hear about A & B Insurance?Do you approve texting?* Yes No Thank you for sharing all of that information with me today. We’re now going to shop your quote with about 20 top-rated insurance companies to make sure you get the best coverage at the best price. We’ll take care of everything and have your personalized options ready for you within the next 24 hours. Do you have any questions or concerns today?*Enter your email below to receive a copy.* Checklist Download the quote sheet from your email Create Prospect in QQ Catalyst Email the Home Team (Inside QQ) Add Prospect to OneDrive Excel Tracker
