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RISK REDUCTION QUESTIONNAIRES
AUTO RISK REDUCTION QUESTIONNAIRE
HOMEOWNERS RISK REDUCTION QUESTIONNAIRE
Homeowners Risk Reduction Questionnaire
Contact Name *
What is your Education Level?
Home Protection Checklist
Have you remodeled your home, built any outbuildings or garages or made any improvements to finish your basement?
If yes, please indicate what you have done and the approximate cost.
Would you like to SAVE 10% - 25% on your Homeowners insurance by increasing your deductible?
Yes - Send Quote
Do you have a Wood Burning or Pellet Stove? *
Do you own a secondary residence that is not insured with Babineau Insurance? *
Have you added or changed an alarm or security system at your home? *
Have you updated the wiring, heating, roof or plumbing in your home in the past year?
Do you own any rental or investments properties not insured with Babineau Insurance? *
Do you own tools, equipment or instruments used in your trade or profession? If yes, please describe.
Cash is limited to $200 on the standard Homeowners policy!! *
Yes, I Understand
New Personal Property
Enter a value for any newly acquired personal property.
Jewelry & Watches
Silver, silverware, goldware, pewter.
Stamp and Coin Collections
Fine Arts and Breakable Items
Antiques or Collectibles
Do you own a trampoline? *
Do you have a tree house? *
Do you have a skateboard ramp? *
Do you own a Firearm? If yes, describe # & type.
Do you have any pets? *
If you have a dog, please indicate breed(s) and age.
Do you have an office, studio or business in your home? If Yes, please describe.
Do you provide any Day Care at your home? *
Do you own any of the following types of vehicles?
(check all that apply)
Additional Coverage Available!
Would you like a quote for Refrigerated Products Coverage? *
Would you like a quote for limited coverage for Backup of sewers, drains and sump pumps? *
Would you like a quote for Earthquake Coverage? *
Would you like a quote for Flood Insurance? *
Would you like a quote for a $1,000,000 Umbrella liability policy that would protect you in the event of a catastrophic event? *
Do you want your home mortgage paid in the event of a death? (You're 30 times more likely to lose your home due to the death of your spouse) If Yes, please enter outstanding Mortgage Amount.
* = Required Field
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