Secure Landlord Insurance Quote Request Form

A standard home policy does not cover a property you rent to someone else. Landlord cover protects the building, the rental income, and you.

Only your name, email and phone are required — fill in what you know and we will come back to you for the rest. Nothing here is an application and nothing is binding.

Your business Business Name

DBA / Trading AsOnly if different from the name above.Business Structure

Business Address

CityZIP Code

Mailing AddressOnly if your mail goes somewhere else.

Your First NameYour Last Name

Email AddressPhone Number

Years in BusinessApproximate Annual RevenueA rough figure is fine.

WebsiteIf you have one.

The property Property Address

Property TypeHow Many Units?

Year BuiltSquare Footage

Construction TypeYear the Roof Was Last Replaced

Year the Electrical Was Last UpdatedYear the Plumbing Was Last Updated

How it is rented

How Is It Let?Monthly Rent

Do You Screen Tenants?Credit or background checks.Do You Use a Property Manager?

Is There a Pool or Spa?Are Pets Allowed?

The cover you want

Cost to Rebuild the PropertyNot the market value.Do You Want Cover for Lost Rent After a Loss?

Liability Limit You WantDo You Own Other Rentals?More than one often qualifies for a better rate.

Your current cover and timing Any claims on this property in the past 5 years?

Current or Previous InsurerIf you are switching or renewing.What You Pay NowIf you know it.

When Do You Need Cover to Start?

Anything Else We Should Know

This is a solicitation for insurance. Completing this form does not apply for or bind cover. Coverage cannot be bound or changed via this form, e-mail, voicemail, text, or facsimile — only by written confirmation from our office.