Welcome to the Cardinal Ins Co Homeowner Quote Form

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Personal Information

Name:

Address:   City:  State: KS    Zip Code: 

Phone:   EMAIL:

Social Sec No.:    Date of Birth: 

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Home Information

Year Built:    Number of Families:   Number of Stories:    Square Feet:

Construction Type:Frame
Masonry
Steel
Other
   Roof Type:asp shinglewoodother

Within City Limits? YesNo    Non-Smokers:

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Installed Protection Devices: (Check all that apply)
Smoke AlarmsFire ExtinguishersDead Bolts
Burglar Alarm MonitoredBurglar Alarm w/ Siren 

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Coverage

Home Replacement Value:   Deductible:5002501000

Liability:300,000100,000500,0001 Million

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Are you interested in any of our other Products? (check all that apply)
Auto InsuranceLife InsuranceMedical InsuranceAnnuities
Boatowners Cycle Ins Business 

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Any Message? Questions? Special Considerations?     Submit below or fax to 785.238.6008

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Cardinal Ins Home Page