Utah insurance quotes from the Lingard Agency
UT insurance
Utah Automobile, Homeowners, and Business Insurance Resources & Quotes On the Web
We Are Utah's #1 Online Insurance Agency - Get a Quote TODAY!
Utah  insurance

Utah insurance
Utah insurance
Visit Our Agency's
Valuable Utah
Insurance Resources:
UT insurance quotes

  Auto Insurance Quotes
  Home Insurance Quotes
  Renters Insurance Quotes
  Condo Insurance Quotes
  Boat Insurance Quotes
  Motorcycle & ATV Quotes

  Business Owners Quotes
  Commercial General Liability
  Business Auto Quotes
  Landlord's Insurance Quotes

  Life Insurance Quotes
  Annuity Quotes

  Service My Account
  About Our Agency & Services
  Read Our Privacy Statement
  Return to Home Page
 

Questions?
We'd Love to
Hear From You.


E-mail Us:
quotes@autoinsuranceforutah.com

The Lingard Agency
5100 S. 375 E. #B5
Ogden, UT 84405
 
Phone: 801-475-0622
Toll Free: 877-475-0623 Fax: 801-475-0623

Insuring Residents
and Businesses
In Utah


Homeowners Insurance
Quotation Form
One Simple Form - takes only 2-3 Minutes!


Your Personal Data:
 
Your Name:
Property Address:
City:
Your "County" is?
State: (Must be Utah)
Zip/Postal:
E-Mail (REQUIRED):
E-Mail again for accuracy:
Phone:
Fax (optional):
 
 
Dwelling Information
 
Year Home Built:
Home Square footage:
 
Is this Builder's Risk?
(new home constr.)
NO YES
 
Month/Year home
to be complete:
 
Number of units: 1 family Duplex
 
Type foundation: Slab
Crawlspace over slab
Pier & Post
Other (list in remarks)
 
Type Construction: Frame
Brick/Veneer
Stone
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:
 
Rate Your Credit History and Past Insurance Payment History:
(Some companies products are
based on your credit and payment history.)
Excellent Fair
Poor Horrible
 
Primary Policyholder's Birthdate:
(Some companies products
offer discounts for certain age groups.)
 
Plumbing type: Copper Galvanized
Mixed (Copper/Galvanized)
 
 
Heating Type: Gas (Propane or natural)
Electric
Oil (if oil, list tank location in remarks)
 
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 $
Liability Cov. $ Deductible $
($250, $500, $1,000, etc.)
 
Comments/Remarks
(describe any scheduled jewelry, in-home business, oil tank location, or other special coverages/remarks here):
 
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.

Yes, I Agree. Please Send Me a Quote NOW!


Click Button Below When Done

Please Click Only Once . . . May take up to 30 seconds!


Terms of Use/Privacy Notice/Copyright Info.    Lingard Insurance Agency    Design © 2007 Insurance-Web-Sales
Please report site-related technical problems to: quotes@autoinsuranceforutah.com (This page last updated June 2007)
Utah insurance quotes