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E-Mail:
info@fivestar
insuranceagency.com

Toll-Free Phone:
1-866-740-4132

Local Phone:
1-678-526-7979

Fax Number:
1-678-526-7222

Office Address:
2093 Rock Chapel Road
Lithonia, GA 30058

Five Star Insurance Agency

Owned and Operated by:
Aisha Smith-Danzy
Since 2006

Proudly Representing:

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Ins. Web Sales, Inc.


Georgia insurance quote

 
 
Landlord's Insurance
Quote Request Form
One Simple Form - takes only 2-3 Minutes!


 
Your Name:
Business Name:
Property Address:
City:
State:
Zip/Postal:
E-Mail (REQUIRED):
E-Mail
(again for accuracy):
Phone:
Fax (optional):
 
 
Dwelling Information
 
Year Building Built:
Building Square footage:
 
Occupancy: Owner Tenant
 
Occupancy Type:
(describe entities & and number of units, such as "4 unit apartment" or "2 offices and barber shop", etc.)
 
Type foundation: Basement
Slab
Crawlspace over slab
Other (list in remarks)
(If basement, what % is finished?)
% FINISHED
 
Type Roof: Shingle Wood Shake
Tar/Gravel Spanish Tile Metal Other
 
Type of Siding Brick   Vinyl
Wood   Aluminum
 
Number of stories: One Two
Three 4 or more
 
# 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:
 
Plumbing type: Copper Galvanized
Mixed (Copper/Galvanized)
 

 
Coverages:
 
Building Cov. $ Contents $
Liability Cov. $ Deductible $
($250, $500, $1,000, etc.)
 
Other Coverage/Remarks
(describe any extra coverages needed such as business interruption, robbery, computers, etc.):
 
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