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President John Aellen John Aellen
President

"We are an agency
you can trust.
Give us a call,
and you'll see the
difference!"

That's Our
GUARANTEE!.

 
 
Landlord's Insurance
Quote Request Form
One Simple Form - takes only 2-3 Minutes!
 
Your Name:
Business Name:
Property Address:
City:
State:
Zip/Postal:
E-Mail (REQUIRED):
E-Mail
(again for accuracy):
Phone:
Fax (optional):
 
 
Dwelling Information
 
Year Building Built:
Building Square footage:
 
Occupancy: Owner Tenant
 
Occupancy Type:
(describe entities & and number of units, such as "4 unit apartment" or "2 offices and barber shop", etc.)
 
Type foundation: Basement
Slab
Crawlspace over slab
Other (list in remarks)
(If basement, what % is finished?)
% FINISHED
 
Type Roof: Shingle Wood Shake
 Tar/Gravel Spanish Tile Metal Other
 
Type of Siding Brick   Vinyl
Wood   Aluminum
 
Number of stories: One Two
Three 4 or more
 
# of feet to nearest
fire hydrant: 		# of miles to nearest
fire station:
 
Currently Insured? Yes No
Name of Carrier & how long insured?
 
Prior Claims? Yes No
Describe claims in detail:
 
Plumbing type: Copper Galvanized
Mixed (Copper/Galvanized)
 

 
Coverages:
 
Building Cov. $ Contents $
Liability Cov. $ Deductible $
($250, $500, $1,000, etc.)
 
Other Coverage/Remarks
(describe any extra coverages needed such as business interruption, robbery, computers, etc.):
 
Send my quotation via: E-Mail Fax
Regular Mail
Call Me by Phone
Thank you for filling out this form COMPLETELY!

We value your input as PRIVATE information. Every step has been taken to insure your privacy, security, and our intent is to release quote information only to you. We will not give your data to ANY other person or group for sales, marketing, or ANY other purposes. By checking the box below you agree to allow our agency to release this information via the method you have chosen, and to release us from any liability should this information be accidentally viewed by others. Our intention is to maintain your complete privacy.

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Landlord's Insurance Quote NOW!

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John Aellen and Associates . 703 Giddings Avenue #L4 . Annapolis, MD 21401
Phone: 410-280-0500 | Fax: 410-280-0361 | E-Mail us at: info@aelleninsurance.com
Our Telephone Quoting Hours are: 9:00am to 5:30pm (Monday-Friday)
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