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    Type of Home:

    Select any additional property features that apply:

    Year Built:  
    Square Footage:

    Is Your Home Located in a Flood Plain?
    Security System

    Construction Type:
    Primary Heating:
    Roof Type:
    Garage Type:

    FOUNDATION:
    Stories:

    Fire Alarm:

    Do You Have Any of the Following Breeds of Dogs: Chow, Doberman, German Shepherd, Pit Bull, Rottweiler, Wolf Hybrid, or a mix of these *

    Policy Information

    Personal Property Amount Required: [select* PersonalPropertyAmtRqd "$30,000" "$50,000" "$75,000" "$100,000" "other"

    Have you reported any claims of losses to your insurance company within the past 5 years? [select* FiledAClaim "Yes" "No"]

    PERSONAL LIABILITY COVERAGE DESIRED:

    WILL THIS INSURANCE REPLACE AN EXISTING POLICY?

    DESIRED DEDUCTIBLE:

    Contact Information


    Toll Free Number:
    (866) QUE-2121


    ​Fax: (862) 243-1277
    ​Email: info@quesurance.com​

    Location:
    446 River Styx Road
    Hopatcong, NJ 07843​

    Agency Hours:
    Weekdays: 9:00am – 5:00pm