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Apartment Bldg. Quote 
Dwelling Fire/Apartment Building Insurance Quote
Name of Business:
Contact Name:
Address:
City:
 State: Zip:
Business Phone:
 Fax Number:
Contact Email Address:
Property Information
Address of Property:
Property City:
Property State:
Property Zip:
New purchase Existing ownership
Number of units:
Building Square footage:
Year Built:
Occupancy:
Owner Tenant
Occupancy Type:
Plumbing type:
 Copper Galvanized Mixed (Copper/Galvanized)
Foundation Type:
 Slab
Crawlspace over slab
Pier & Post
 Other (list in remarks)
Type finished basement, if any:
 None Full 25% 50% 75%
Type Roof:
 Shingle
Wood Shake
Tar/Gravel
Spanish Tile
Metal
Other
Type of Siding:
 Brick Vinyl Wood Aluminum
Number of stories:
 1 2 3 4 or more
# of feet to nearest fire hydrant:
# of miles to nearest fire station:
Currently Insured?
Name of Carrier & how long insured?
 Yes No
Coverage's
Building Coverage
 $
Liability Coverage
 $
Contents
 $
Deductible $
($250, $500, $1,000, etc.)
 $
Other Coverage/Remarks:
(describe any extra coverage's needed such as business interruption, robbery, computers, etc.):
Any claims reported on this property or previously owned properties in the last 3 years?
 Yes No
Please describe: Include date(s) and details of claim:

Additional Comments
Please give any additional comments or questions

No coverage of any kind is bound or implied by submitting information via this online form

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“We have been working with Winooski Insurance for over 10 years. Joe keeps us abreast of any and all new regulations that might have an impact on our industry or business. Because of this we have enjoyed nice dividend checks from our workers comp carrier. Contact Joe or one of his staff for any of your insurance needs.”

Mike Gervais
Prime Renovation Group, Dream Maker Bath & Kitchen of Vermont

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Mortgage Financial, Inc.


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