How many homes do you own, lease or rent?

Are you considering getting a new home in the near future? Yes     No

Have you paid your home off? Yes     No

Do you have a dog? Yes     No

If yes, what is the breed:

Do you have a trampoline? Yes     No

Does your home have a burglar alarm? Yes     No

Do you have pool? Yes     No

Do you have a business running our of your home?
Yes     No

Do you own jewelry valued at more than $1000 per item? Yes     No

Do you own any firearms valued at more than $1000 per item? Yes     No

Do you own any collectibles valued at more than $500 per item? Yes     No

Do you own any antiques valued at more than $500 per item? Yes     No

Is your house prone to flooding? Yes     No

Are you concerned about identity theft? Yes     No

Do you have an outdoor or underground oil tank?
Yes     No

Have you added an addition to your house in the past 3 years? Yes     No

Would you like us to tell you about extra liability insurance for your home and auto? Yes     No

Would you like us to give you a competitive auto insurance quote, which would also lower your homeowners insurance premium? Yes     No

Phone:

Email:

Insured Signature: (please type name)

Date:

Thanking you in advance for taking the time to complete this questionnaire. As always, if you may have any questions please contact us at (508) 533-8914.

Testimonial
Ted,
Just a short note to say thanks for getting me great price on my car and home insurance. With all the new insurers now competing for my business by promising to "beat" what I am currently paying I didn't think Reardon Insurance could compete with some of their prices. Well, you proved me wrong. You continue to earn my business every year with competitive pricing and great service from your staff.
Brian
Mendon, MA