Lighthouse Insurance Services

In Independent Agency Representing Erie Insurance Group

Home

About Us

Contact Us

Policies Offered

Auto Insurance

Homeowners Insurance

Business Insurance

Life Insurance

Quotes Online

Pay your ERIE bill

News/Events

For The Kids Charity

Directions

Feedback

Service Partners

Teen Lookin Out

 
Want an Auto Quote?
First Name
Middle Name
Last Name
Address Line 1
Address Line 2
City
State
Zip Code
D.O.B.
E-mail Address
Daytime Phone() -
Evening Phone() -
Any claims, tickets or accidents in the last 3 years?
If YES - explain what happened
Was there a pay out for the accident? How much?
Occupation
Highest grade completed
Spouse's name
Any other licensed drivers in the household? Who?
Own? Rent?
Vehicle Year
Vehicle Make and Model
VIN#
Primary driver
Driver's license #
Approx. miles to work?
Current coverages:
Currently covered by?
How did you hear about us?
Want a Homeowner's Quote?
First Name
Middle Name
Last Name
Address Line 1
Address Line 2
City
State
Zip Code
D.O.B.
E-mail Address
Daytime Phone() -
Evening Phone() -
Are you purchasing a home? If so what is the settlement date
Are you looking to switch companies?
Current Insurance Company
Any homeowner claims in past 5 years:
Have you had any insurance canceled, refused or expired? explain
Is household non-smoking?
Current Dwelling Coverage Amount:
Current Personal Property Coverage Amount:
Current Other Structure Coverage Amount:
Current Loss of Use Coverage Amount:
Current Liability Coverage Amount:
Current Medical Pay Coverage Amount:
Square Footage
Sales Price/Market Value
Current Annual Premium
Deductible
Liability Limit
Year Construction of Dwelling
Do you have a Central Alarm System
Age of Electric
Type of Electric
Type of Plumbing
Type of Roof
Age of Roof
Type of Furnace
Age of Furnace
Number of Floors
Number of Bathrooms
Number of Bedrooms
Does the house have a basement? Is it a full basement? Is it finished?
Type if house? Condo? Split level? Coloniel? Single Family? Townhouse? Other?
Do you have a garage? If Yes how many cars? Is it attached?
Does the house have a deck or porch?
Name of closest fire department. How many miles from your house?
Are there fire hydrants in your neighborhood? How close in feet to your house?
Do you have a pool on the premises? If Yes - Is it above or in ground?
Any wood stoves, wood burning stoves, space heaters or kerosene heaters? If Yes - type?
Sole source of heat?
Are there any fireplaces?
Does the pool have a 3 ft fence with a lock?
Will any business be contucted on the premises?
Are there any roomers or boarders in the house?
Are there any children? If Yes - Names and Birthdates?
Are there any pets? If Yes - type of breed?
Just want some questions answered?
First Name
Middle Name
Last Name
Address Line 1
Address Line 2
City
State
Zip Code
E-mail Address
Daytime Phone() -
Evening Phone() -
Quote for what type of insurance?
© 2009 Lighthouse - Insurance™ 
1119 Maryland Route 3N, Suite 210, Gambrills, MD 21054, Phone   410-721-6000 ~ Fax (410) 721-5985<>
Questions, Comments or Corrections, contact: cclark@lighthouse-insurance.com

NOTICE OF LICENSURE Lighthouse - Insurance, Inc ™ is licensed to conduct business in Maryland.
The information on this site is a solicitation to conduct business only in the aforementioned state of authority.
ERIE is a registered service mark of Erie Insurance Exchange.

Insurance Crofton | Home Insurance Odenton | Car Insurance Gambrills | Home Insurance Quotes Bowie | Auto Insurance Quotes MD | Insurance Maryland | Homeowners Insurance Crofton | Auto Insurance Maryland |  | Sitemap

Local Internet Advertising provided by Ads Next™

Website powered by Network Solutions®