 |
| For: |
Agent's Name |
| Lead ID: |
26743 |
| Insurance Type: |
Homeowner |
| Date: |
07/28/2002 |
|
|
| Contact Information |
|
| Need Quote: |
ASAP |
Best Day: |
Anyday |
| |
|
Best Time: |
Anytime |
| Name: |
John Doe |
Day Phone: |
(850) 256-1276 x 23 |
| Address: |
4536 Alaska ave |
Evening Phone: |
(850) 722-0310 |
| City: |
Kalskag |
Cell Phone: |
(878) 310-2386 |
| County: |
Bethel |
Fax: |
(850) 722-0310 |
| State: |
AK |
Email: |
johndow@email.com |
| Zip Code: |
99607 |
Alternate Email: |
johndow@altemail.com |
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|
|
|
| Current Residence: |
Own |
Yrs Current Residence: |
Less than 1 year |
| Newly Purchased: |
Yes |
Yrs Previous Residence: |
5+ years |
| Currently Insured: |
No |
Applicant's Birthdate: |
01/18/1961 |
| Current Carrier: |
|
Credit History: |
Excellent |
| Renewal Date: |
|
Social Security #: |
615-23-6583 |
|
|
| Property Information |
| Address: |
4536 Alaska ave |
Property Type: |
Single Family |
| City, County: |
Anchorage, Anchorage |
Occupancy: |
Primary Residence |
| State, Zip Code: |
AK, 99515 |
Construction Class: |
Standard |
| Proximity to water: |
Not Applicable |
Construction Type: |
Wood Frame |
|
| Fire Department: |
Anchorage Fire Department |
Roof Type: |
Asphalt Shingle |
| Built Year: |
1995 |
Exterior Walls: |
Mostly Brick |
| Major Upgrades: |
2001 |
Foundation: |
Basement |
| Garage Type: |
Not Attached - 3 Cars |
Stories: |
2 |
| Heating Type: |
Electric |
Square Footage: |
3,500 |
| Wiring Type: |
Copper |
Bedrooms / Bathrooms: |
4 / 3 |
| Panel Type: |
Circuit Breaker |
Fireplaces / Decks: |
2 / 1 |
| Content Value: |
$30,000 |
Alarm: |
Monitoring Company |
| Dwelling Value: |
$200,000 |
Dog: |
No |
|
| Additional Features: |
| Deadbolt locks, Smoke alarm, Fire extinguisher, Manned fire station (within 5 miles), Fire hydrant (within 1000 feet), Copper water pipes, Flood area, Central air conditioning |
|
| Coverage Requested |
| Coverage: |
Full Package |
Sewer Backup Protection: |
No |
| Liability Protection: |
$300,000 |
Earthquake Protection: |
No |
| Deductible: |
$1,000 |
|
|
|
|
|
| Claims |
| Date: |
7/2002 |
Claim Type: |
Fire |
Amount: |
$6,000.00 |
| Comments: |
Short in dryer receptacle |
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| Comments: Please, contact me ASAP! |
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