FI
Flagstaff Insurance
Homeowners application

Homeowners Insurance Application

The full underwriting application for your Flagstaff home. Complete what you know — we'll follow up on anything left blank. Questions while you fill it out? Call 928-235-2151.

928-235-2151 josh@contractorschoiceagency.com

281 fields across 7 sections. Just want a fast estimate instead? Request a quick quote.

1. Applicant and Policy Information
2. Property, Occupancy, and Ownership

Home-based business conducted on premises?

Any customers or employees visit the premises?

Any room, unit, or structure rented to others?

Any short-term rental activity (Airbnb/VRBO)?

3. Dwelling Construction and Building Details
4. Utilities, Systems, Protection, and Updates

Any knob-and-tube, aluminum, or cloth wiring?

Any polybutylene, galvanized, or lead plumbing?

Any active leaks, unrepaired damage, or maintenance issues?

Any open permits or code violations?

5. Premises Liability and Underwriting Exposures

Any firearms kept on premises?

Any wood stove, fireplace, or solid-fuel appliance?

Any unusually steep terrain, retaining wall, or cliff exposure?

Any prior foreclosure, bankruptcy, or insurance cancellation?

Any resident with a felony conviction or fraud-related offense?

6. Coverage Selection and Valuation
7. Loss History, Mortgagee, Remarks, and Authorization

By submitting this application you authorize Flagstaff Insurance to obtain the reports needed to quote and bind coverage. Nothing here binds coverage until a carrier issues a policy.

Your information is used only to quote your coverage.