Kratzer Insurance Incorporated
26 Millrace Road, PO Box 2, Mt. Pleasant Mills, PA 17853
Phone (570) 539-8801 ,Fax (570) 539-4205
Email:
kim@kratzerinsurance.com
347 Water Street, Northumberland, PA 17857
Phone (570) 473-3544 , Fax (570) 473-3546
Email:
ray@kratzerinsurance.com
Please complete the information below to process your Homeowners quote?
Contact information:
Name:
Address:
Address (cont.)
City:
State & Zip:
Social Security Number:
Phone:
Best Time to Call:
Email:
Location of Property:
County:
Amount of Coverage:
Loss of Use:
Other Structures:
Liability
Deductible:
Year Built/Construction Type
$250
$500
$1000
$2500
/
Frame
Masonry
Type of Heat: Other:
Wood Stove/Location
Heatpump
GeoThermal
Electric BaseBoard
Oil Hot Water Furnace
Oil Hot Air Furnace
Natural Gas
Other
Yes
No
/
Square Footage:
Roof Type:
Protective Devices:
Miles to Fire Department/Distance to Fire Hydrant
/
Dog(s)/Type?
Trampoline Pool Fence
Yes
No
/
Yes
No
Yes
No
Yes
No
Business conducted on premises?/What Kind?
Any Losses:
Yes
No
/
Yes
No
Do you currently have Insurance?/Who?
How Long
Yes
No
/
Mortgagee Name:
Mortgagee Address:
Mortgagee State & Zip:
Last Updated on:
12/24/2008
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