Request for Quote for Homeowners Insurance

Request for Quote for Homeowner's Insurance

Here is your opportunity to get a free, no-obligation homeowners insurance quote. Just follow the instructions below and when you have completed the form press the submit button. Your request will be handle by one of our staff members as soon as possible.

Instructions: Please complete as much of the form below as possible. We do not require that you complete all the information below, but please complete as much information as you can for the most accurate quote.

If you prefer, phone our office for a quote at (301) 229-1500

E-Mail

Personal Information
Name
Address
City	State Zip
Email Address
Home Phone	Work Phone
Fax
Contact Me Via:	(please select from list below)
First Choice		Second Choice

Current Homeowners Insurance Information
Current Homeowner Insurance Carrier
Expiration Date
How Long With Current Carrier
Current Automobile Insurance Carrier	(optional)

Home Information
Desired Liability Coverage	$100,000 $300,00 $500,000 $1,000,000
Current Dwelling Value
Year Home Was Built
How Long Have You Lived There
Type Construction
Type of Roof	Age of Roof
Type of Plumbing	Age of Plumbing
Type of Electric	Age of Electric
Type of Heating	Age of Heating
Options	Smoke Detectors
	Fire Alarm Connected to Monitoring Service
Burglar Alarm Connected to Monitoring Service
Fire Protection	Distance to Fire Hydrant
	Distance to Fire Department
Note: Homeowners insurance does not cover floods. If you are interest in providing broader coverage to include insurance against floods please indicate so in the comments block below.
Do you operate a business from your home? Yes No
(If Yes, what type of business is it?)
Do you have any pets? Yes No (If yes, please list type and breed)
Have you submitted any claims in the past five years? Yes No If so, please describe (include date(s) of loss and amount(s) paid)
Have you ever been refused, canceled, expired or non-renewed? Yes No
Note: Many homeowner policies contain special limits of liability on items such as gold, silver, coins and other precious metals as well as jewelry, furs, silverware, pewter, firearms, watercrafts, fine arts, and business personal property. Arrangements to enhance your policy can be made to provide a much broader coverage. If you desire this coverage please indicate so in the comments block below.
Do you have any special hobby or items that you would like specifically insured?Yes No
(If yes, please list them here)

Comments / Remarks

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Henry A. Latimer & Son, Inc. is licensed to conduct
business in Maryland, Virginia and District of Columbia.
The information on this site is a solicitation to conduct
business only in the aforementioned states of authority.

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