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Full Name:
Date of Birth:
Street Address:
 
City:
State:
Zip:
Day Phone:
Evening Phone:
Best time to contact:
Email:

# of Adults in Household:
Year Built:
Square Feet:
Stories:
Full Baths:
Half Baths:
Bathroom Style:
Kitchen Style:
Roof Type:
Age of Roof (in years):
Garage Type:
# Car Garage:
Interior Walls:
Cathedral Ceiling %:
Basement % of Ground Floor:
Basement % Finished:
Walkout Basement:
Exterior: Must Equal 100%: Surface: Percent:
 
 
 
 
Interior Walls: Must Equal 100% Surface: Percent:
 
 
 
 
Floors: Must Equal 100% Surface: Percent:
 
 
 
 
Wall Height:
Framing:
Air Conditioning:
 Fireplace:
Chimney:
Balcony:
Pool:
Elaborate Roof:
Approximate Home Value
(do not include land):

Features:
Additional Furnace Central Vacuum Greenhouse Hot Tub
Central Stereo Spiral Staircase Patio Cover Open Porch
Jacuzzi Solar Room Wood Deck Composite Deck
Redwood Deck Open Breezeway Screened Breezeway Intercom

Atrium Doors Atrium Windows Bay Windows Exterior Shutters
French Doors Greenhouse Windows Picture Windows Skylights
Sliding Glass Doors Solar Panels Stained Glass Windows Wet Bar

Prior Losses:
Losses: Less than 24 Months Losses: More than 24 Months

Discounts/Surcharges:
Married Nonsmoker Central Burglar Alarm Central Fire Alarm Local Burglar Alarm

Desired Coverage:
Personal Liability:
Guest Medical:
Desired Deductible:
Flood Insurance:
Earthquake Insurance:
Umbrella:

Comments:


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     Your home is most likely your largest and most important asset. Yet, your current agent has probably never taken the time to personally take a look at it. Our agency personally views every home we insure, and takes photographs for our files. In the event your home is damaged or destroyed, we want to make sure you are able to build the same home you lost.

    Farmers Next Generation Home Owners policy has many extra coverages that you don't have to ask for...they're included. Some companies offer them as options and some don't offer them at all. For a free, no obligation quote, please complete the form below and you will promptly be contacted with more information. Below the form are definitions to aid your understanding of available coverages. We look forward to providing you with excellent service.

See what coverages come standard with every Next Generation Homeowners Policy

Compare Farmers homeowners insurance to other companies.

Homeowners Insurance 101 Video


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Applicants with Credit or Loss Problems

"I'll never be able to get insurance with this loss on my record." Just because it may seem impossible doesn't mean that it's true. We help many people get insurance, despite it feeling impossible to them. Just because your life isn't perfect, doesn't mean you shouldn't have coverage.

Earthquake Coverage

Does the ground shake around your house? It may and you may not even realize it. Earthquake Coverage and California Earthquake Authority Coverage protects you from earthquake damage and is an available option in many states.

Flood Insurance

Chances are, if you live in a flood plain, you should, and may even be required, to have Flood insurance as part of your Homeowners policy. As part of the National Flood Insurance Program, you are able to purchase protection, against flood damages, in most areas.

Identity Fraud Expense Coverage

You receive a call asking if you recently spent a large sum of money. You feel the pit of your stomach sink as you can't help but think your identity's been stolen. Don't let theft, literally, ruin your good name. Identity Fraud Expense Coverage helps you recover losses when your name and reputation has been taken from you.

Landlord

If you own single or multiple properties that you rent out, you may have special insurance needs. That's why we provide Landlord insurance. It is specially tailored to meet the unique needs of property owners.

Mobile and Manufactured Homes

So your home isn't a traditional "stick built" on a foundation. That doesn't mean that you don't need homeowners insurance. We insure a variety of home types. From mobile to manufactured, to multi-sectional to modular, and more, we can make sure that your home is protected.

Motor Homes

It's time to get out on the open road. And, now more than ever before, your home might be on the open road. Motor home Coverage makes sure your home is covered, even if it isn't necessarily on a permanent foundation.

Personal Liability Coverage

Are you protected if someone is injured on your property or if you damage another's property? Personal Liability protection makes sure that you are covered against the things that you can be held liable for.

Personal Property Coverage

Are your wedding bands or other valuables covered? What about your home entertainment system? Personal Property Coverage can make sure that these items and your personal belongings are protected.

Personal Umbrella Liability Coverage

An umbrella, exactly what it says, shelters us from a great deal of losses. Given today's litigious society, we could stand to lose a lot if we end up in a lawsuit. A Personal Umbrella Policy serves to shelter you from losses or loopholes in coverage.

Renters

Just because you don't own the property you live in, doesn't mean that your valuables shouldn't be insured. Did you know that your personal property isn't covered under your landlord's insurance policy? Renters insurance helps to make sure your prized possessions are covered when your renting your home.

Residential

For many of us, our home is one of our most valuable and prized possessions. There is nothing quite like the wonderful feeling of a having a place to call home, and nothing worse than the sinking feeling of losing it. Residential Homeowner's insurance helps to make sure that we will have a home in the event that the unexpected occurs.

Specialty Homeowners

We provide a variety of Homeowner Coverage options for providing protection for the following types of specialty properties: older and lower value homes, landlord properties, homes with minor cosmetic problems, homes with market value below replacement cost, and more.

Travel Trailers

Taking your home on the road? Whether you have a fifth-wheel, travel trailer, pop-up or truck-mounted camper, we have coverage to make sure that your home away from home is protected.