Brown & Brown Insurance of MN, Mankato. Your Local Independent Insurance Agency
© 2010 Brown & Brown of MN, Inc. Mankato
530 West Pleasant Street, Suite 100
Mankato, Minnesota 56001
Phone (507) 388-2010
Homeowner's Online Quote Form
Name
Street Address
City, State, Zip
Date of Birth
Telephone
Email Address
How do you prefer to be contacted?
Phone
Email
Mail
Dwelling Insured Amount?
Current Liability Amount?
Current Deductible?
Any claims in the past 3 years?
Yes
No
Don't Know
If yes, please explain:
Any recent updates?
Electrical
Furnace
Roof
Plumbing
Other
Any scheduled items such as jewelry, silverwear, fine arts, etc?
Yes
No
Don't Know
If yes, please explain:
Year Built:
Structure Type:
Frame
Brick
Square Feet:
How many full baths?
0
1
2
3
4
5+
How many half baths?
0
1
2
3
4
5+
Central Air?
Yes
No
Basement?
Full Finished
Partially Finished
Not Finished
No Basement
If partially finished, approximately what percent is completed?
Decks or Porches?
Deck
Porch
None
If you do have a deck and/or porch, please specify the approximate square feet:
Fireplace?
Yes, 1
Yes, 2
Yes, 3
No
Garage?
Yes, Attached
Yes, Detached
No
If you have a garage, how many stalls?
1
2
3+
Extra Features?
Pool
Hot Tub
Other
If other, please specify:
How did you hear about us?
Google
Yahoo!
Other Search Engine
A Friend
At the Mall
Online Link
Radio Ad
I Don't Know
Submit
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