IN insurance quotes from Oetting Insurance

Low cost IN insurance quotes from Oetting Insurance Agency
IN insurance quotes from Oetting Insurance Agency
Indiana insurance quotes from Oetting Agency
Indiana insurance quotes from Oetting Insurance Agency

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Indiana insurance quotes from Oetting Insurance Agency
 
Farm & Ranch Online
Insurance Quote Form
One Simple Form - takes only 2-3 Minutes!


Your Personal Data:
 
Your Name:
Business/Company Name:
Property Address:
City:
State:
Zip/Postal:
E-Mail (REQUIRED):
E-Mail
(again for accuracy):
Phone:
Fax (optional):
 
Building/Dwelling Information
 
Year Dwelling Built:
Home Square footage:
 
Number of units: 1 family Duplex
Triplex Four Units
 
Occupancy: Owner Tenant
 
Type foundation: Slab Crawlspace over slab
Pier & Post Other (list in remarks)
 
Type Roof: Shingle Wood Shake
Tar/Gravel Spanish Tile
Metal Other
 
Number of stories: One 1.5
Two Three
 
Do you own animals or pets? Yes No
If yes, list type/for dogs, list breed:
 
Are You Near Brush Area? Yes No
 
# 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)
 
Circuit Breakers or fuses? Breakers Fuses

 
Underwriting Information:
 
Ownership & Payroll Data:
List Employee's Annual Payroll Here (if none, enter $0): $ Insert # of
Employees here:
 
Location & Sales Information:
Insert Annual Gross Revenues from this operation here: $ Square Footage of office or business location:
 
Type of Building (wood frame, concrete, etc.): Number of Stories:
 
Are there other business/residences in this building (describe)?: Describe safety features (alarm, sprinklers, fire protection, etc):
 
Coverage Desired: (Check One Please)
The Coverage I Am Looking For:

Liability Only
Liability & Business Contents
Liability, Building & Contents Coverage
A Package Policy Including the Above,
        Plus Miscellaneous Coverages

NOTE: Don't worry if you are not exactly sure about coverage type... we will suggest the best coverage for you - just try to tell us what you are looking for! (If we need more info. we will let you know.)
 
Liability Coverage:
($300,000, $500,000, $1 Million, etc.)
$
 
Business Contents Coverage:
(The amount of your personal business property)
$
 
Building Coverage:
(The amount of building coverage if you own your bldg.)
$
 
Miscellaneous Coverage:
(List any special coverage peculiar to your business, such as Garagekeepers Legal, Loss of Earnings, Valuable Papers, etc.)
$
 

 
Farmowner Underwriting Information:
 
How Many Acres? What Variety(s) of Trees?
 
Yearly Income from Growing Operations $ Number of Workers on Site:

 
Send my quotation via: E-Mail Fax
Regular Mail
Call Me by Phone

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Oetting Insurance

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Oetting Insurance Agency  |  10848 Rose Avenue, Suite 2  |  New Haven, IN 46774  | Office Map Driving Directions
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