Randy Jones Insurance Services Serving Bay Area, Pleasanton

Home Insurance Quote

First Name
Last Name
Address
City
Zip
Phone #
Email
Year Home Built
Number of Stories
Square Footage
Claims in the last 5 yrs?	Yes No
Member of an Association? If yes, enter assoc name
Exterior
Siding	Wood Stucco Other
Roof	Tile Comp Wood Shake Metal
Foundation	Raised Foundation Slab
Pool?	Yes No Spa? Yes No
Garage (Number of Cars)
Carports (Number of Cars)
Balcony (Square Footage)
Deck (Square Footage)
Interior
Number of skylights/bay windows/atrium
Flooring	%Carpet %Tile %Wood %Vinyl
Walls	%Paint %Wood Paneling %Wallpaper
Counter tops	Granite Marble Tile Formica Other
Number of Fire Places
Number of Baths
Number of Half Baths
Number of French Doors
Number of Wet Bars
Laundry Location
Water Heater Location
Forced Air Conditioning/Heating	Yes No
Protective Devices
Indoor Sprinklers	Yes No
Smoke Detector	Yes No
Fire Alarm
Burglar Alarm
Fire Extinguisher	Yes No
Deadbolts	Yes No
Gated Community	Yes No

Interested in Home Mortgage Protection?	Yes No