Librandi Insurance
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Insuring New Yorkers Since 1996
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Homeowners Insurance Application

Please fill out the below form to the best of your ability for your FREE insurance quote. If you are unsure of any question you can leave it blank or call 516-541-2800 for more information. When you complete the form click "Submit" on the bottom and we will get back to you very shortly. Thank you !
 

[FrontPage Save Results Component]
1- Name
2- Address
3- Home #
4- Cell #
5- Email Address
Coverage's  
6- Dwelling coverage ( if known )
7- Is this a ... New Purchase    Current owner 
8-  If "New" Purchase" Purchase Price $   

Mortgage Amount $ 

9- What is the construction of house? Frame    Brick 
10- Year built?
11- Square feet?
12- Alarm system? Yes    No 
13-  If "Yes" Burglar    Fire    Burglar & Fire 
Years of renovation  
14- Wiring
15- Plumbing
16- Heating
17- Roofing
18- Owner occupied? Yes    No 
19- Tenant occupied? Yes    No 
20- If "Yes", monthly rent amount?
21- Swimming Pool Yes    No 
22-  If "Yes" In ground    Above ground 
23- Distance to water? Less then 1 mile    More then 1 mile 
24- Number of stories? 1 story    2 story    Tri-level 
25- Is there a basement? Yes    No 
26-  If "Yes" Finished    Unfinished 
27- Do you own a dog? Yes    No 
28- If "Yes", breed & age
29- Do you have a trampoline on your property? Yes    No 
30- Which do you have in your electric panel? Circuit Breakers    Fuses 
31- Is the primary source of heat thermostatically controlled? Yes    No 
32- Do you have any prior Homeowners claims? Yes    No 
33- If "Yes", when & what type of claim?
   
34- How did you hear about us?

 

Thank you. Please click submit below and we will get back to you with

the best rate available in the New York area

 

 

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FREE QUOTES
 
Simply click any of the links on the left for a FREE insurance quote. At Librandi Insurance we strive to provide our clients with the best available rates to them to the New York area.
 
 
NEED INSURANCE ?
 
Do you need insurance right away in the New York area? Not sure what coverage to get? Not happy with your current rates or company? We are here to help. Call us and get the service you deserve.....
 
516-541-2800
 We cover all of the New York area including Long Island, Brooklyn, Bronx, Staten Island, Manhattan, Queens