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Toll Free: 888-283-0096

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Request a Quote - Renters Insurance

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Information provided will be kept confidential and used for quoting purposes only. All quotes are based on the information given and are subject to change upon further inspection. Coverage can not be bound via e-mail or internet service.
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Conrade Insurance Offices

129 E. Broadway
Newton, KS 67114-0547

Phone: 316-283-0096
Fax: 316-283-2444

info@conradeinsurance.com

Applicant Information

Name:  
SSN:       Date of Birth:
Street Address:  
City:       State:       ZIP:
County:  
E-Mail Address:   
Home Phone:     Work Phone:

Residence Information

Year of Construction:
Type of Dwelling:
How Many Family Units Per Bldg:  
Type of Construction:  
  • Frame: Constructed of wood frame, covered with wood or vinyl. Less than 50% of exterior is brick or stone.
  • Masonry Veneer: 50% or more of the exterior is brick or masonry but has wood frame construction.
  • Masonry: Constructed entirely of face brick, common brick, stone or split block.
Is daycare provided on the residence premises? Yes   No
Is residence premises within city limits Yes   No
Is there a trampoline on the residence premises? Yes   No
Is there a pool on the residence premises? Yes   No
Do you own a dog(s)?

Yes  No

If yes, list breed(s)
Select all that apply::

Smoke Detectors
Monitored Alarm System
Wood Stove or any other Solid Fuel Heating Appliance
Dead Bolts
Interior Sprinkler System

Feet from home to nearest fire hydrant:
Miles to nearest fire department:

Coverage Amounts

Amount of coverage requested for personal property:  
Amount of coverage requested for personal liability:
Amount of deductible requested:
Secret Word:
Please enter the word you see above into the secret word field. This field helps prevent spammers.

 

 

Phone: 316-283-0096
Toll Free: 888-283-0096
Fax: 316-283-2444

129 E. Broadway, Suite 200
P.O. Box 547
Newton, Ks 67114-0547

ClientConnect

www.conradeinsurance.com
info@conradeinsurance.com

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