Condo Quote Request

Condominium Quote Request
Please provide the information below to obtain a condominium (HO-6) quote from our agency. The information will be emailed to a representative of
Piper-McCredie and will be in touch. *Please note currently we are only writing HO-6 policies in the state of Michigan.

Your Name:

Address:

City:
State: Zip:

Telephone:

E-mail:

Year Built:

# of Units in Building:

Type of Construction:

Desired Content Amount:

Desired Liability Limit:

Desired Deductible:

Credits: (Check any that apply)
Non-Smoker
Smoke Detector (1 per level)
Fire Extinguishers (1 per level)
Dead Bolt Lock (All exterior doors)

Alarm System

Any Business Use in the Condo? Yes No
Any Claims in the Last 3 Years? Yes No
Is the Condo Rented During the Year? : Yes No

Additions & Alteratioins: (Not covered by Association, example upgrades at the time of construction, or by you since then)

Extras:
Condo Plus Endorsement
$5,000 Sewer/Sump Back-Up Coverage

Remarks: (any questions, comments, or list any scheduled item limits)

Click "submit" to forward your information to us.
Click "reset" to reset the form and start over.

5454 Gateway Centre, Suite A • Flint, MI 48507-3932 • Phone (810) 767-6050 • (800) 333-0983 • Fax (810) 767-7323
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