AARP Umbrella Commercial Homeowners Auto

Church Quote Forms


Fill out the following form as completely as possible. Once you have completed the form, click the Submit button to send your information. Your request will be handled promptly.

Name of Church
Required
Street
Required
City
Required
State
Required
ZIP / Postal Code
Required
Primary Phone Number
Required
E-Mail Address
Required
Denomination
Required
Average Weekly Attendance
Optional
Number of Employees
Required
Lein Holder Information
Stained Glass Windows Yes or No
Optional
List of any Losses, Type and Amount, in last 3 yrs.
Optional
Number of buildings
Optional
Current Building Limits
Optional
Current Contents Limit
Optional
Approximate square footage
Optional
Smoke or Burglar alarm - Yes or No
Optional
Approximate square footage
Optional
Approximate square footage
Optional
Construction Type
Optional
Electrical System (fuse or Breaker)
Optional
Are any of the alarms monitored by a central station?
Optional
Smoke or Burglar - Yes or No
Optional
Sprinklered- Yes or No
Optional
Submission Validation
Required
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Important Notice
Any submissions or payments made via this website do not constitute a binding agreement to your policy or coverages. Changes and payments to policies are not effective or binding until you, or any party involved, receive official notice from either your insurance agent, or your insurance company. If you have any questions, please feel free to contact us.

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