Wallis and Wallis Insurance Brokers - Serving the San Jose Bay Area since 1977

Homeowner's Association Insurance Quote

Please fill in the following fields, providing as much information as possible.

* denotes required fields

General Questions
Contact Name*
First Name Last Name
Phone Number*
- Area Code Phone Number
E-mail
HOA Information
HOA's Name*
Expiration Date of Current Policy
Month Day Year
Name of Current Carrier
Number of Board Members*
Monthly HOA Dues per Individual*
Do you wish to have earthquake insurance quoted?*
Do you currently have flood insurance?*
Please list any claims the HOA may have had in the last four years:
Date
Month Day Year
Description
Date
Month Day Year
Description
Date
Month Day Year
Description
Building and Premises Information
Year Built*
Total Number of Units*
Total Number of Separate Buildings on the Premises*
Approximate Square Footage of Each Unit*
Building Construction*
Type of Roof*
Fireplaces in Units?*
Parking*
Is the building equipped with fire sprinklers?*
Fire Alarms?*
Please list the years of any updates that may have been completed for the following:
Electrical
HVAC
Plumbing
Roof
Please describe any pools, cabanas, club houses, tennis courts or any other community structures that are on the premises:
Should be Empty: