Georgia insurance

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Georgia auto insurance
Georgia auto insurance
Home Insurance | Auto Insurance | Life Insurance | Renters Insurance | Landlord Liability | Builders Risk
Georgia auto insurance
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GA homeowners insurance

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5 Reasons Why You Should Use Our Insurance Services:

1. Excellent coverage at very competitive prices.

2. FAST online quotations for auto, homeowners, and life, and INSTANT quotes by phone.

3. Low down payment & Easy monthly installments on most policies.

4. Our service is second to none. Call us and get an agent who really CARES!

5. We offer a satisfaction guarantee. We know our top quality coverages and service will SATISFY you!

"All Our Policies Come With an Agent!"

Clemmons Insurance Agencies has helped thousands of Georgia, Tennessee, South Carolina, and Missouri residents and businesses find the lowest rates available and the best insurance plans to protect their cars, homes, businesses, and families. Let us do the same for YOU! Our office includes a state-of-the-art computer system for policy services, claim servicing and accounting so that quality service is GUARANTEED. Your needs will be addressed, phone calls returned, and coverage issues responded to, and claim matters will be addressed...WITHIN 24 HOURS!

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Homeowners Insurance
Quotation Form
For Mortgage Brokers/Real Estate Agents
One Simple Form - takes only 2-3 Minutes!

Agent/Broker's Name & Company:
Agent/Broker's Phone #:
Agent/Broker's Fax #:
Your Client's Personal Data:

Your Name:
Property Address:
Your "County" is?
E-Mail again for accuracy:
Home or Work Phone:
Fax or Cell # (indicate which):
Best # and Time to Contact You:
Dwelling Information
Type of Dwelling: Home Condo
Duplex Townhome
Do, or will you: Own Home
Rent Home
Own AND Rent to Others
Year Home Built:
Home Square footage:
If new purchase, when is
escrow closing date?
Current Home Market Value: $
Number of units: 1 family Duplex
Type foundation: Slab
Pier & Post
Other (list in remarks)
Type Construction: Frame/Siding
Other (list in remarks)
Type Roof: Shingle
Wood Shake
Spanish Tile
Metal Other
Number of stories: One 1.5
Split Level
Two Three
Garage Information: No garage
1 Car 2 Car
3 Car
Garage Type: Built in
Attached Detached
Carport? Yes No
Does home have basement? Yes No
List % of basement that is finished:
Do you own a dog? Yes No
If yes, list type/for dogs, list breed:
# of feet to nearest
fire hydrant:
# of miles to nearest
fire station:
Name of Fire Department, if known:
Currently Insured? Yes No
Name of Carrier & how long insured?
Prior Claims? Yes No
List Year, and Type of claim:
Primary Policyholder's Birthdate:
(Some companies products
offer discounts for certain age groups.)
Spouse's Name & Birthdate:
(If not married, leave blank.)
Heating Type: Gas (Propane or natural)
Central HVAC? Yes No
Dead bolts? Yes No
Smoke Detectors? Yes No
Monitored Alarm System? Yes No
Circuit Breakers or fuses? Breakers Fuses

# Bedrooms: # of full and 1/2 Baths:
Fireplace?: Yes No Chimney? Yes No
Deck? Yes No   - if yes, Size: Small Med. Large
Wood Burning Stove in Home? Yes No

Dwelling Cov. $ Deductible $
($250, $500, $1,000, etc.)
Select Contents Coverage: 60% of Dwelling Amt.
75% of Dwelling Amt.
Select Liability Coverage: $100,000
(describe any scheduled jewelry, in-home business, swimming pool, barn, or other special coverages/remarks here):
Send my quotation via: E-Mail Fax
Regular Mail
Call Me By Phone

Thank you for filling out this form COMPLETELY!

We value your input as PRIVATE information. Every step has been taken to insure your privacy, security, and our intent is to release quote information only to you. We will not give your data to ANY other person or group for sales, marketing, or ANY other purposes. By checking the box below you agree to allow our agency to release this information via the method you have chosen, and to release us from any liability should this information be accidentally viewed by others. Our intention is to maintain your complete privacy.

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GA auto insurance
Please contact our agency at the address and phone numbers below for a free quotation today. We have the service you are looking for!

Clemmons Insurance Agencies - Smyrna, GA Office
1326 Concord Road, Smyrna, GA 30080
Phone: 770-434-6691
Fax: 770-434-6779
Email: Click Here to Email Us | Click for Map/Directions

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