Bishop White Insurance & Financial Services, Inc. PO Box 71401 2135 NW 108th St Clive, IA 50325
515-777-8540 Alternate: 319-610-9223 Jason@Bishop-White.com
Jason is asking...
Home Insurance
Auto Insurance
Commercial Insurance
Other...
What is the model year of your vehicle?
This vehicle is...
New
Used
Owned
Financed
Leased
This vehicle is primarily used for...
Commuting (work and/or school)
Pleasure (when the mood strikes)
Business (my car works for me)
I usually drive...
This vehicle is used for...
Work and/or School Commute Details
Gender
Rent or Own?
I was licensed before age 18 in the US/Canada
Military or Government Affiliation
Birthday:
Is this a business?
Year your business was started.
Do you have a DBA?("Doing Business As")
This is a home-based business.
I have multiple locations.
I own this location.
Coverage Start Date:
Are there current claims with this business?
Are you currently insured?
Are you in need of liability coverage?
Are you insuring a property?
What year was your building built?
I own this location
Does Your Building Have...
Burglar Alarm?
Fire Alarm?
Smoke Detectors?
Sprinkler System?
Listed Business Address:
Address of the property being insured:
Have you lived here longer than 3 years?
What year was your home built?
This property is a...
House
Condo/Townhouse
Other
When did you purchase your home?
Is this your primary residence?
The property has a...
Garage
Carport
Neither
Do you have a pool?
Do you have a deck?
Do you have a porch?
Do you have a fireplace?
The foundation of this property is...
Basement
Crawlspace
Slab
Piers
Select any safety devices your home has:
Burglar alarm that sounds
Fire alarm that reports to a fire station or security company
Multiple fire sprinklers throughout your home
A backup generator
Home automation system
Have you made any claims in the past five years?
Do you smoke?
Do you have a dog(s)?
Meet Jason G. Grams, CIC