Home Information

• Quote For*
• Street Address*
• City*
• State*
  Ohio

  Superior Insurance Services is only licensed in Ohio

• Zip*
• County*
• Township*
• City Limits*
  Select One Inside City Limits Outside City Limits
• Fire Dept*
• Distance to Fire Dept.*
  Select One Less than or equal to 5 miles Greater than 5 miles
• Distance to Hydrant*
  Select One Less than or equal to 1000 ft. Greater than 1000 ft.
• Home Phone*
• Cell Phone*
• Work Phone*
• Email*
• Mortgagee*
• Date Purchased*
• Escrow*

Home Details

• Year Built*
• Living Space (Sq. Ft.)*
• # of Stories*
• Type of Roof*
  Select One Asphalt Metal Slate Wood
• # of Bedrooms*
• # of Full Baths*
• # of Half Baths*
• Enclosed Porch (Sq Ft.)*
• Open Porch (Sq Ft.)*
• Wood Deck (Sq Ft.)*
• Type of Heat*
  Select One Baseboard Boiler Furnace Heat Pump
• Type of Electrical*
  Select One Breaker Fuse
• Type of Plumbing*
  Select One Cast Iron Copper Plastic PEX Steel
• Home Security*
  Select One Yes No
• Central Alarm*
  Select One Yes No
• Interior Walls*
  Select One Drywall Plaster
• Carport/Garage*
  Select One Carport-Attached Carport-Detached Garage-Attached Garage-Detached
• Carport/Gar. # of Cars*
• Other Structures*
• 
  

  Exterior Walls:

• % Alum/Vinyl*
• % Brick Over Frame*
• % Brick*
• % Wood*
• 
  

  Basement:

• % Furnished*
• % Ground*
• % Crawl*
• % Slab*

Risks/Extras

Renovations

Other