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Builders Risk Quote Form


Fill out the following form as completely as possible. Once you have completed the form, click the Submit button to send your information. Your request will be handled promptly.

Contact Information
First Name
Required
Last Name
Required
DBA
Optional
Street
Required
City
Required
State
Required
ZIP / Postal Code
Required
Primary Phone Number
Required
Fax Number
Optional
E-Mail Address
Required
Site Information
Is the Builder different than the Name Insured
Required
If "Yes", Builders Name
Optional
Street Address
Optional
City, State. ZIP Code
Optional
Phone Number
Optional
Property Location
Required
City
Required
State
Required
County
Required
Purchase Price of Property
Required
Amount of Renovation To Be Completed
Required
Property Construction Type
Required
If "Other", please explain
Optional
Year Built
Required
Square Footage of Location
Optional
Site Updates
Year Electrical System Updated
Optional
Year Heating System Updated
Required
Year Roof Updated
Required
Type of Construction
Required
Effective Date
Required
/ /
Type of Policy
Required
Type of Business
Required
Does Builder/Remodeler have at least two (2) years experience
Required
Years of Experience
Required
Business Description
Required
If "Remodeler", any work involving load bearing walls
Optional
Year Constructed
Required
Is the remodeling work on the existing structure to begin within 60 days of the effective date
Required
Number of structures built/remodeled during the past 12 months
Required
Number of structures projected for the next 12 months
Required
Prior Claims
Required
If "Yes", please provide claim details, including amount of claim
Optional
Is the location apartments, condominiums, or multi-unit
Required
Where and how are materials stored
Required
What preventative measures are taken to mitigate losses from windstorm
Required
Estimated lenght of project
Required
Type of security to be provided
Required
Mortgage Company
Optional
Street Address
Optional
City, State, and ZIP Code
Optional
Phone Number
Optional
How did you hear about us?
Required
Submission Validation
Required
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Important Notice
Any submissions or payments made via this website do not constitute a binding agreement to your policy or coverages. Changes and payments to policies are not effective or binding until you, or any party involved, receive official notice from either your insurance agent, or your insurance company. If you have any questions, please feel free to contact us.

Per the terms of our online privacy policy we will not resell your information to any third-party.
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Toll Free: 1-844-595-3313|Local: 713-655-0335|Fax: 832.834.4261 2201 Caroline|Houston, TX 77002
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