Arizona insurance quotes from Schaller Family Insurance of Phoenix, AZ
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Local Phone: 623-580-8688
Fax: 866-292-0830

Contact Address:
Schaller Family Insurance
21620 N 19th Ave., Suite A-7
Phoenix, AZ 85027

"Remember, All Our Policies Come With an Agent!"

 
On-Line Flood
Insurance Quote Form
One Simple Form - takes only 2-3 Minutes!


Your Name:
Property Address:
City:
State: (Must be Arizona)
Zip/Postal:
E-Mail (REQUIRED):
E-Mail (again for accuracy):
Phone:
Fax (optional):
 
Dwelling Information
Year Home Built:
 
Home Square footage:
 
Flood ZONE NUMBER:
(look on current policy, if any)
 
Flood COMMUNITY NUMBER:
(look on current policy, if any.)
 
Number of units: 1 family Duplex
3 Family 4 Family
 
Type foundation: Slab Crawlspace over slab
Pier & Post Other (list in remarks)
 
Type Roof: Shingle Wood Shake
Tar/Gravel Spanish Tile
 
Number of stories: One 1.5
Two Three
If more than 1 story, are some contents on ground floor, contents ONLY above the first floor? On ground floor
Above first floor only
 
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

# Bedrooms: # Bathrooms:
 
# Fireplaces: # Chimneys:
 
Special features
(i.e., deck, air conditioning, alarm systems, pool, etc.)
 
Coverages:
Dwelling Cov. $ Contents $
Deductible $
($250, $500, $1,000, etc.)
 
 
Comments/Remarks:
 
Send my quotation via: E-Mail Fax
Regular Mail
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Schaller Family Insurance | 21620 N 19th Avenue, Suite A-7 | Phoenix, AZ 85027 | Phone: 623-580-8688 | Fax: 866-292-0830
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