Home or Rental Insurance Quote
Please fill out the short form below. If you have it available, please send your current declaration page to toditah@wexfordins.com so we can compare coverages.
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Full Name & Date of Birth *
Primary Policy Holder
Phone Number & Email *
Additional Owners or Co-Applicants *
Full Names & Date of Birth. If no additional parties, type NONE
Current Home Address *
Ex: 123 Main Street City, State, Zip Code & Apt/Unit # if applicable
Future Home Address *
Ex: 123 Main Street City, State, Zip Code & Apt/Unit # if applicable
Requested Effective Date *
(Home Purchase Date or Effective Date of Coverage)
Do you currently have home or rental insurance, if so with who? *
 If no current insurance, type NO. You can send your current declaration page to toditah@wexfordins.com.
Occupancy Type *
Has the roof been replaced or updated? *
If yes, type when was it replaced in Other. Select N/A if it doesn't apply.
Has the wiring been replaced or updated? *
If yes, type when was it replaced in Other. Select N/A if it doesn't apply.
Has the plumbing been replaced or updated? *
If yes, type when was it replaced in Other. Select N/A if it doesn't apply.
Has the HVAC (Heating and Air Conditioning Unit) been replaced? *
If yes, type when was it replaced in Other. Select N/A if it doesn't apply.
Are any of the following at the residence? *
Select all that apply.
Required
Is the home undergoing any construction, renovation, or reconstruction? *
Has there to your knowledge been any property losses or claims at the residence? *
Will any businesses occupy this property? *
If you are running a business out of your home, you may need a business policy in addition to a home policy. Make sure you are properted properly. 
Permission to Run Reports *
In order to get the most accurate quote possible, insurance companies run reports which contain property claim histories as well as gather information from credit bureaus to generate a credit based insurance score and properly rate your policy. This is NOT a hard pull on your credit and we do NOT ask for your social security number. If bundling with auto, only your vehicle, driving and claim history are shared with the agent, not your credit report. Property claim history and Motor Vehicle Reports reports are required before an insurance company can bind a policy. Do we have permission to run reports in order to give the most accurate quote? If so, please type I Agree below. 
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