Blue Ridge Insurance & Title Agency
  Phone: 540.955.1178 (540)955-1178   Email Us
Blue Ridge Insurance & Title Agency

Independent Insurance Agent
Independent Insurance Agent

Trusted Choice

Blue Ridge Insurance & Title Agency

Homeowner's Policy Renewal Protection Checklist

Please complete the form below so that we may assist you in maintaining the proper coverage at the best rate on your homeowner's policy. One of our representatives will contact you shortly after receiving this notification.

Policy Holder Information
Please be sure to supply your phone number and email address
so that we may contact you after receiving this notification.
Form Completed By:
Phone #: Work     Home   Cell

Renewal Protection Checklist
Please indicate
Yes, No, or Insured (meaning you already have the coverage)
Yes No Insured
Have you remodeled your home, added any additions, built any outbuilding or garages, or made any improvements to finish your basement?:
Have you refinanced or changed your mortgage company this year?: 
If so name, address, and loan number:  
I would like to SAVE 10%-23% on my property insurance by INCREASING my deductible. Please let me know what the savings would be.:
Have you acquired any valuable guns, jewelry, furs or collectable items?:
Do you want your home paid for in the event of a death? 
(You're 30 times more likely to lose a home because of a death of a spouse.):
Do you own a second home such as a weekend or summer property? 
If so what is the address?:  
Would it cost more to rebuild your home than the amount you have it insured?: 
(We can help you calculate the estimated replacement cost)
Have you added a new security or fire alarm system to your home?:
Do you own any ATVs, boats, snowmobiles, or other recreational vehicles?:
If your home is 40 years old or older, have you updated the wiring, heating, roof or plumbing in your home?:
Do you have a trampoline?:
Do you have any pets? 
If so what kind and how many?:  
Would you be interested in obtaining information on a $1,000,000 umbrella liability insurance policy that would protect you in the event of a catastrophic accident?:
Do you run a business or give private lessons out of your home? 
If so, please give details:  
Are you babysitting two or more children in your home on a regular basis?:
Do you have any rental or investment properties?:
Would you like to have Flood coverage?:
Would you like to have Earthquake coverage?:
Would you like to have backup of sewer or drain coverage?:

Additional Comments
Please give any additional comments you feel appropriate for this checklist.

Please click on the "Submit Form" button to send your service request.
One of our representatives will respond to your submission as soon as possible.


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Blue Ridge Insurance & Title Agency Blue Ridge Insurance & Title Agency
Blue Ridge Insurance & Title Agency
110 S. Church Street
Berryville, Virginia 22611
Blue Ridge Insurance & Title Agency
Blue Ridge Insurance & Title Agency

Important Note:   This website provides only a simplified description of coverages and is not a statement of contract. Coverage may not apply in all states.
For complete details of coverages, conditions, limits and losses not covered, be sure to read the policy, including all endorsements.
Blue Ridge Insurance & Title Agency
Blue Ridge Insurance & Title Agency
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