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Ames Insurance Agency has moved back to their original location. We have also had our website overhauled by JPDiamond Company. Let us know what you think.
 

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Get a Quote For Home Insurance
Ames Insurance is an independent agency, which means we write insurance for many different companies.  By completing the questionnaire below you will give us the necessary information to offer you an accurate quote.

Fill out this questionnaire completely for a free quote! (or e-mail us and ask us to contact you)
First and Last Name:
Address:
City: State:   Zip:
Home Phone (with area code):
Work Phone (with area code):
Fax Number (with area code):
E-mail address:
Contact us: Current Residence Status:
If insured, what is the name of your insurance company?
If insured, what form of insurance?
If insured, what is your renewal date?   
Is this quote for a new home purchase?
If yes, when is your closing date?   
Is, or will your homeowner premium be paid from an Escrow account?

Residence Data

HOMEOWNERS ONLY
Amount of coverage on dwelling: (e.g. $150,000) - $

Do you have a mortgage, home-equity,
or other loan against your house?

 
RENTERS, CONDOMINIUM, TOWN HOME ONLY
Amount of coverage on personal property:
( Minimum of $10,000) - $
 
Deductible Amount: Construction Type:
Design Type: Basement:
Roof Construction:
Approximate year residence was built:

Is there a fire hydrant within
1000 feet of your home?

Check all that apply:
Smoke Detectors Deadbolts on final exit doors Fire Extinguisher
Central Fire Wood Burning Stove Central Burglar
Do you have a swimming pool?
Do you have a dog?
If yes, what is the breed?
If yes, has your dog ever bitten anyone?

 
Replacement Cost Generator-Room Count

Please check all that apply (include any finished rooms in basement):
Kitchen Living Room Dining Room
Study Family Room Office
Den
Bedrooms Bathrooms
Unfinished Attic Tile or Slate Roof Stone/Brick
Exterior Walls
Unfinished basement
Garage Dinette or Breakfast Nook
Central Air Enclosed Porch Foyer
Walk-in Closet Work, Storage,or Laundry Room
Breezeway Open Porch Deck
Central Vacuum Wet Bar Sauna
# of Fireplaces Jetted Tub

Improvements/Renovations/Utilities

How many years has it been since you re-roofed your house?
What type of fuel/energy do you use to heat your house?

If gas, how old is your furnace?

If electric, do you have fuses or circuit breakers?

How old is your electric service?

How many Amps is your electric service?

What type of wiring do you have?

 
Claims/Loss Information

Please describe any Claims or Losses you've had in the past 3 years:
 

 
Mortgage Protection

In the event that one of the principal owners die, would you like to have the mortgage paid off?

If YES, please provide answers to the questions below.
All others proceed to Questions/Comments.

The approximate amount to pay off the mortgage:
The approximate number of years left to pay on your mortgage:
First Name: Age: Sex: Smoker

 
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