|
Oakland Insurance Agency Broker | CF&P Insurance Brokers
The
web menu
provided by f-source.com. All Rights Reserved
Insurance Applications - Personal
GO TO: COMMERCIAL APPLICATIONS
PLEASE SELECT A BROKER:
PLEASE SELECT
James Cantwell
Paul Coupin
Michael Crist
Robert Crist
Marc Dronkers
Jack Fritschi
Jeff Fritschi
Tom Paterson
Tom Smith
* Required
HOMEOWNERS INSURANCE
Proposed effective date
Applicant Name
Phone Number
(
)
Email Address
* Required
Mailing Address
Property Address, if Different
Wood Frame Construction
YES
NO
Year Built
Structure Type
SINGLE FAMILY DWELLING
CONDO
TOWNHOUSE
Type of Foundation
BASEMENT
CRAWLSPACE
SLAB
Square Footage
Stories
Occupancy
OWNER
TENANT
If Owner Occupied
PRIMARY
SECONDARY
Heat Type
GAS
ELECTRIC
Fuses
YES
NO
Circuit Breakers
YES
NO
Roof Material
Composition Shingle
Tile
Tar / Gravel
Wood Shake
Is the Foundation Seismically Retrofitted
YES
NO
Swimming Pool
YES
NO
Burglar Alarm
YES
NO
- If Yes, Central Station
YES
NO
Central Station Fire Alarm
YES
NO
Fire Sprinklers
YES
NO
Smoke Detectors
YES
NO
Year of Major Updates
A. Wiring:
B. Plumbing:
C: Roof:
D. Heating:
Requested Dwelling Replacement Limit
Additional Coverage for Jewelry, Fine Arts, Collectibles or Silverware
YES
NO
Owner Birthdates
Any Owned Autos
YES
NO
CF&P insurance | P.O. Box 1979 | Oakland, CA 94604 | OFFICE PHONE (510) 433-4200
