Property Management E-Quote

E-Quote by One Link Software is designed to gather information needed to provide you an accurate insurance quote on dwellings (one-family through four-family), condominium units, and town homes that you own, but which you lease out to a tenant or tenants. Vacant dwellings are not eligible for coverage in this program.
A minimum of information is required. Change default entries if applicable.

Questions may be directed to Chris Bloxsom with GBMB via telephone at (800) 216-1170 or via email at chrisb@gbmbinsurance.com.

Information
Your Name:
Email Address:
Phone Number: () -
What date would you
like coverage to start?
General Information What is the address of your tenant-occupied dwelling?
Street Address:
City/County:
State: TX
Zip Code:
Tell us what type of dwelling you wish to insure:
Is this dwelling currently vacant?
Is this dwelling your secondary residence,
i.e. do you occupy it seasonally or on a part-time basis?
In what year was your dwelling built?
What is the square footage of your dwelling?
Is this dwelling your primary residence?
Do you occupy any part of this dwelling?
Does dwelling have a composition (asphalt) shingle roof?
What was the last year roof was replaced?
If never replaced, enter year that dwelling was built.
NOTE: Roofs over 25 years old will be excluded from coverage.
Contact servicing agent with questions.
Underwriting Information
What is the replacement cost of your dwelling?
Please DO NOT include the value of the lot or land where dwelling is situated.
?
Would you like to include coverage for Loss of Rents? ?
Please provide amount of rents collected each month:
Would you like to include coverage for acts of terrorism?
Does the dwelling have any existing damage?
Does anyone conduct business on the premises?
(Examples might be a day care, beauty shop, auto repair, etc.)
Is there a swimming pool on the premises?
Would you like to include liability coverage for the pool?
Is the dwelling taller than 2 stories in height?
Does the dwelling have copper wiring with circuit breaker protection?

You, the applicant, confirm that the information provided above is true and correct to the best of your knowledge, and you understand that any quote provided is based on this information.

ANY PERSON WHO KNOWINGLY AND WITH INTENT TO DEFRAUD ANY INSURANCE COMPANY OR ANOTHER PERSON FILES AN APPLICATION FOR INSURANCE OR STATEMENT OF CLAIM CONTAINING ANY MATERIALLY FALSE INFORMATION, OR CONCEALS FOR THE PURPOSE OF MISLEADING, THE INFORMATION CONCERNING ANY FACT MATERIAL THERETO, COMMITS A FRAUDULENT INSURANCE ACT, WHICH IS A CRIME AND SUBJECTS THE PERSON TO CRIMINAL AND [NY: SUBSTANTIAL] CIVIL PENALTIES. (NOT APPLICABLE IN CO, HI, NE, OH, OK, OR, VT; IN DC, LA ME AND VA, INSURANCE BENEFITS MAY ALSO BE DENIED.)