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Homeowners
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Aloha Insurance eBinder

 
Homeowners / Dwelling Fire Insurance Quote
Policy Holder Information
Name(s) to appear on Policy
Mailing Address
City, State and Zip
Telephone Number
Fax Number
E-Mail Adddress

 

Property Information
Physical Address
City, State and Zip
Name of Condo Complex / Project
Tax Map Key Number (TMK)
If your property does not have a TMK Number, please provide the following: Year built, square footage of living area, square footage of garage or carport, square footage of any lanais or porches, description and square footage of any other structures attached to the house.
Amount of coverage needed
to replace dwelling
Does property feature a swimming pool? Is it fenced? Diving Board?
Hurricane Coverage? If yes, select type
Flood Coverage? If yes, select type
Earthquake Coverage? If yes, select type
Power supplied by electric company? Description of Other
Water supplied by the County? Description of Other
If catchment system, capacity in gallons

 

If Property is Over 25 Years Old
Name of contractor who performed the latest roof repair or replacement and date of work
Name of contractor who performed the latest electrical upgrade or repair and date of work
Name of contractor who performed the latest plumbing upgrade or repair and date of work
Date of last exterior painting

 

Occupancy Information
Who will occupy the property?
If owner occupied, is this your primary or secondary residence?
If this is your primary residence, would you like a home/auto package quote?
If this is your secondary residence, is there a live-in or part time caretaker or property manage?
Will a property manager be listed as an additional insured?

 

Rental Property Information
Will you be renting any part of the property?
If so, how many tenants?
Short term or long term rentals?
Will the property be furnished?
Amount of coverage desired for furnishings

 

Other Information
Are there any in-home business activities in the dwelling or farming on the property?
If yes, please provide details.
Are there any pets or livestock on the property?
If yes, please provide details.
Are there any items or structures requiring coverage that are not attached to the main dwelling? ( Swimming pool, detached garage, storage building, fencing, etc.)?
If yes, please provide details and amount of coverage desired.
Any prior claims?
If yes, please provide details.

 

Portions courtesy of and © Insurance Information Institute (www.iii.org) Copyright © 2001-2016 Aloha Insurance Services, Inc. Kona HI All rights reserved.
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