Bowen, Miclette & Britt Insurance Agency, LLC

Apply Online for a Homeowner's Insurnace Quote

Policy Holder
Contact Name *
Email *
Phone Number
Property Location
Address
Address 2
City
State
Zip
Current Insurance Information
Company Name
Current Annual Premium
Expiration Date
General Information
Estimated Replacement Cost
(whole dollars)
Estimated Year House was built
Number of stories excluding basement
Type of Construction
Structures not attached to the house
Deductable Desired
Amount of Liability
County of
Have you Filed Bankruptcy within the past 7 years? Yes  No
Other Features of Your Home
(Check all below that apply)
Home Features Deadbolt Locks
Smoke Detectors
Fire Extinguisher
Sprinkler System
Central Station Fire Alarm
Central Station Burglar Alarm
Home Located within 5 miles of a manned fire station
Home located within 1000 feet of a fire hydrant
Swimming Pool
Trampoline
Home Located within City Limits
More than 5 acres of land
Satellite Dish
Own a Dog Breed
Any business conducted on premises? Yes  No
Claims
List any claims in past 3 years:
  Date Amount Paid Claim Type Description
1.
2.
3.
Personal Property
Estimated value of your personal property:
Jewelry & Watches
Furs
Silver
Firearms
Stamp and Coin Collections
Fine Arts and Breakable Items
* = Required Field
Disclaimer Notice - The premiums quoted are estimates based on information you provided. This quotation does not constitute a contract of insurance, nor does it provide coverage for any loss or claim. Coverage can only be bound by an agent with a signed application and a down payment.
Send