Metro Boston Insurance
Agency

Experience Is The Difference

Package Your Auto and Home and Save
up to 30%617-884-5480

Home Quote

Home Insurance Quote

We would like to provide you with a free , no-obligation home insurance quote.
Please provide as much information possible for the most accurate quote.
This information will be kept confidential and will be used for quote purposes only.

Speak to an agent or a live representative....617-884-5480

Customer Information

First Name: *

Last Name: *

Street Address: *

City: *

State:

Zip:

Day-Time Phone:

Area Code

Phone Number

Cell/Other Phone:

Area Code

Phone Number

Email Adress: *

Current Residential Status:

Current Homeowners InsuranceInformation

Do you currently have homeowners insurance?

Home Information

Primary or Secondary residence

How Long at Present Address:

Estimate Year of Construction:

What type of home is it?

Do you conduct business in home?

Sq. Footage:

# of Claims In Last 3 Years:

Amount of insurance needed (approx $ amt - ie $200,000)

How much liability insurance?

Deductible:

Home Type:

Other Type

Construction:

Other Construction

Roof:

Other Roof

Age Roof

Foundation:

Other Foundation

Garage:

Garage size:

Features

Bathrooms

# of Full:

# of Half:

Deck/Porch/Patio

Deck Sq. Ft:

Porch Sq. Ft:

Screened Patio Sq. Ft:

Central Air:

Central Vac:

Security Alarm:

Sprinklers:

Smoke Detector:

Swimming Pool:

Diving Board:

Trampoline:

Service Panel Type:

Additional Features

Do you own any pets? (how many?)

Marital Status

How would you describe your credit rating?

Please list any jewelry or specialty items(i.e.) engagement ring

What else can we help you with?

Do you need Auto Insurance?(Additional discounts may apply):

Addition Comments

Please give any additional comments you feel appropriate for this quotation. If you have additional where there was not enough space, please enter them here.

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