Ask for a quote - House Form Please fill this form and then we prepare a quote for you "*" indicates required fields 1Owner2The building3Options4The content5Insurance and claim history STEP 1 - The ownerFirst name*Last name*Date of birth* DD slash MM slash YYYY Phone or email*Family status*Occupation*Permanent address* STEP 2 - The buildingType of building House Apartment Total Sqm m²*Floor (apartment) Ground floor Intermediate floor Top floor Home First home Second home Construction date*Building address*Number of bedrooms*Number of salons / dining rooms*Number of offices / playing rooms*Other rooms > 7 m² (except kitchen, bath, toilets, garage, laundry)*Others Veranda Closed fireplace (closed chimney, insert or stove) Closed fireplace installed by a professionnal Number of dependencies building(s)*Dependencies sqm ( m² )* STEP 3 - OptionsNew for old* On furnitures (max 10 years on electrical appliances) On building Additional options* Seasonal rental Chambres d'hôtes (max 5 units) Concrete swimming pool Renewable energy (Solar or photovoltaic panels, PAC...) Trees, outside facilities (pergola, fences, specific terrace...) Important informations for the insurer STEP 4 - The contentContent (min 10 000 €)Jewelery theft cover up to (€)Jewelry, watch ... over €200 with invoice or certificate ...Valuables theft cover up to (€)A valuable is an object over €5 000 (referenced painting, beautiful carpet or clock , music instrument ....)Alarm Alarm with professionnal platform remote monitoring STEP 5 - Insurance and claim historyNumber of claims (36 months)TheftLiabilityLeakFire / ElectricalNatural disasterOtherCompany*Duration (years)*Renewall date (échéance principale)* DD slash MM slash YYYY CAPTCHA
