Coverage for your home Get a free homeowners insurance quote* emailed to you: Where is the house located? Is it in a fire district?   Yes No   If so, which one? Are you within a 1000 feet of a fire hydrant?   Yes No Are you inside city limits?   Yes No Construction of home? Any loses in past five years?   Yes No If so, what kind? Nature? Amount of damage? How is house heated? Do you have a wood stove?   Yes No If so, is it UL approved?   Yes No Is it the only source of heat?   Yes No How old is the house? If over 25 years old, has wiring, plumbing, heating and roof been updated? Yes No Which of the following do you own? (Check all that apply): smoke detector dead bolt locks to all exterior doors fire extinguisher Amount of coverage you would like? $ What would be replacement cost of the home? $ Do you have a swimming pool?   Yes No   Is it fenced?   Yes No Do you have any dogs?   Yes No What kind? Do you have a satellite dish antenna?   Yes No Is there a mortgage?   Yes No Do you have coverage on the house now?   Yes No Do you have the replacement cost on contents endorsement HO-290? Yes No Do you own any tenant property - dwellings rented to others? Yes No What is your deductible? What company writes your automobile insurance? Date of birth   Email address Name Address   City State   Zip Home phone     Work phone   Tate's Insurance & Financial Services, Inc. Email: tates@tatesinsurance.com 945 N. Main Street · PO Box 548 Marion, NC 28752 Telephone [828] 652-7414 103 Mitchell Avenue · PO Box 48 Bakersville, NC 28705 Telephone [828] 688-9203 Fixed insurance office only Website design & maintenance by: DeZineShoppe.com *All estimated quotes are non-binding.

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