AGIS Serving Metro Milwaukee - Low Cost Home Insurance - Renters Insurance

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Call 262-641-9800 for your Free, No Obligation Homeowners Insurance or Renters Insurance Quote! To request an insurance price quote 24 hours a day just Complete the form Below!

Your home is the center of your daily life, and likely your most valuable asset. When your home is damaged or destroyed, you need your claim settled by an insurance company that understands this simple fact. AGIS Insurance Center can help you find the homeowner's insurance that will best meet your needs and provide the most valuable combination of tailored coverage, quality service and fair pricing.

Insurance for All Kinds of Homes

Depending on where you live - a house, apartment, or condominium - the right home insurance policy can provide you peace of mind as well as the money you need to repair or replace your home and/or belongings. Contact us for more information today!

PERSONAL INFORMATION
Name:	First:
	Last:
E-mail address:
Phone numbers:	Daytime:
	Evening:
	Fax:
How would you prefer to be contacted regarding your quote?	Phone Fax Mail E-mail
Best time to contact:	AM PM
Address:
City:
State:
Zip code:
Social security number:
Occupation:
Date of birth:
Employer:
STRUCTURAL INFORMATION
What is the style of your home?
How many stories is your home?
How many rooms do you have?
What is the total square footage of the living area of your home?
WHAT IS THE STRUCTURE OF THE FOLLOWING
Roof:
Exterior of your home:
Foundation:
Most of the inside walls consist of:
Most flooring consists of:
Garage:
What is the replacement cost of your home:
HOW MANY OF THE FOLLOWING DO YOU HAVE IN YOUR HOME
Full bathrooms:
Half bathrooms:
Fireplaces:
Decks:
Enclosed porches:
Open porches:
DO YOU HAVE THE FOLLOWING IN YOUR HOME
Swimming pool?	Yes No
Trampoline?	Yes No
Burglar alarm?
Sprinkler system?
Kerosene, wood or oil stove?	Yes No
Dog?	Yes No
Computer?	Yes No
Livestock?	Yes No
Unusual/exotic pets?	Yes No
IS YOUR HOME LOCATED
Within 1000 feet from a fire hydrant?	Yes No
Within 5 miles from the firestation?	Yes No
On a hillside?	Yes No
Close to a body of water or susceptible to flooding?	Yes No
GENERAL QUESTIONS
Year home built:
Number of families living in the home:
What part of the year is the home occupied?
Heating and cooling system:
What term best describes your kitchen?
Is business conducted on the premises?	Yes No
Does anyone in your home smoke?	Yes No
Did you experience any loss or claims in the last 5 years?	Yes No
PROTECTIVE DEVICES
Smoke detectors?	Yes No
Fire extinguishers?	Yes No
Fire alarm?
Deadbolt locks?	Yes No
ADDITIONAL INFORMATION
Gated community with a security guard:	Yes No
Neighborhood watch program:	Yes No
Senior citizen discount (all occupants age 55 or above):	Yes No
HOMEOWNERS COVERAGES AND DEDUCTIBLES
Dwelling (Coverage A - Replacement cost of your home):	$
Other structure (Coverage B - Typically 10% of coverage A):	$
Personal property/contents (Coverage C - Typically 50% of coverage A):	$
Loss of use of your home (Coverage D - Typically 20% of coverage A):	$
Personal liability:	$
Medical payments:	$
Desired deductible:	$
ADDITIONAL DATA
Quote requested within:	24 hrs 48 hrs 72 hrs 120 hrs
Do you want an umbrella quote:
OPTIONAL QUESTIONS
If you have a collection that is anything of value such as Coins, Stamps, Art etc., specify the value of your collection:	$
If you have any furs or jewelry, please specify the approximate value/limits:	$
Do you have any special interests or hobbies that could be considered a home based business?	Yes No
Do you travel?	Yes No
Do you travel outside of the United States?	Yes No
When you travel, do you bring valuables such as watches, jewelry, or furs with you?	Yes No
Do you buy things while traveling and want to know that they are immediately insured under your policy?	Yes No
If your home were destroyed, would you want to rebuild it in the same location?	Yes No
Do you have/want backup of sewers and drain coverage?	Yes No

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AGIS Insurance Center, Inc.
205 Bishops Way Suite 202
Brookfield, WI 53005
Phone: 262-641-9800
Email:AGIS.HOME@agisins.com

Hours of Operation:

Monday - Thursday 8:30am to 5:00 pm CST

Friday 8:30am to 4:00 pm (8:30am to 1:00pm Memorial day thru Labor Day)

Or by Appointment

image shows a house indicating homeowners insurance or home insurance a car indicating car insurance or auto insurance a computer indicating business insurance and a family holding hands indicating life insurance

AGIS Insurance Center

205 Bishops Way Suite 202

Brookfield, WI 53005

262-641-9800

888-781-2220

(Located in Bishops Woods,

Abor Terrace II building)