Stone's General Insurance
 
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Stone's General Insurance  .  21394  Great Mills Road  .  Lexington Park, Maryland  20653-0547
Phone : 301 - 862 - 5100  .  Fax : 301 - 862 - 5102  .  Harry  D. Stone - Broker
Office Hours are : Monday - Thursday  9:00  to  5:00  .  Friday  9:00  to  7:00  .  Saturday  9:00  to  12:00
E-Mail Us At: quotes@stonesgeneralins.net © 2007  .  Website Design © 2007 . Creative Printings
About  Us
 
Service My Account
Having Trouble?   Same Day Coverage!
      Monday - Thursday  9 a.m. - 5 p.m.   
    Extended Hours Friday 9 a.m. - 7 p.m.
            Saturday  9 a.m.  - 12 p.m.
Call (301) 862 - 5100
Your  Personal  Data
Homeowners Insurance Quote Form
Name: ( * Required )
Street Address:
City:
County:
State:
Must be MARYLAND !
Zip / Postal Code:
E- Mail: ( * Required )
E- Mail: ( *  Confirm )
Phone: ( * Required )
Fax: ( Optional )
Dwelling  Information
Year Home Built:
Square Footage of Home:
Is this Builder's Risk?
Yes
No
( New Home Constr.)
Month / Year  Home to be complete:
Single Family
Townhome
Condominium
Other ( List in Remarks )
Dwelling Type:
Crawlspace over slab
Other ( List in Remarks )
Slab
Pier & Post
Foundation Type:
Construction Type:
Frame
Stone
Brick / Veneer
Other ( List in Remarks )
Wood Shake
Spanish Tile
Flat Roof ( Tar & Gravel )
Other ( List in Remarks )
Roof Type:
Metal
Shingle
Number of stories:
One
Two
Three
Split
Other  (List in Remarks )
Electrical Type:
Fuses
Circuit Breakers
Plumbing Type:
CPVC
Copper
Galvanized
Mixed ( Copper / Galvanized )
Electric
Gas ( Propane or Natural )
Oil ( If oil, List tank location in remarks )
Other  ( List in Remarks )
Heating Type:
Number of Bedrooms:
Number of Bathrooms:
Number of Fireplaces:
Number of Chimneys:
Deck
Pool
Alarm System
Special Features:
( Check all that apply )
Yes
Do you own animals or pets?
If yes, list type / for dogs list breed:
No
Yes
Do you have Waterfront Property?
No
Yes
No
Are you in a brush area?
Number of feet to nearest fire hydrant:
Number of miles to nearest fire department:
No fire hydrants
a rural area with no fire
Check here if you live in
hydrants:
Coverages
Yes
No
Currently Insured?
Name of Carrier:
How long with current carrier?
Yes
No
Prior Claims?
Describe any claims in detail:
Primary Policyholder's Birthdate:
Some Companies products offer
discounts for certain age groups
Coverage Required
Dwelling Coverage $
Liability  Coverage $
Content Coverage $
Deductible $
( $250, $500, 
$1,000 etc.)
Comments / Remarks:
Describe any scheduled
jewelry, oil tank location,
or other special coverages
Send my quote via:
E- Mail
Fax
Regular Mail
By Phone
__________________________________________________________________
Thank you for filling out this form COMPLETELY !
We value your input as PRIVATE information. Every step has been taken to insure your
privacy and security. Our intent is to release quote information only to you. We will not
give your data to ANY other person or group for sales, marketing, or ANY other purposes.
By checking the box below you agree to allow our agency to release this information via
the method you have chosen, and to release us from any liability should this information
be accidentally viewed by others. It is our intention to maintain your complete privacy.
Yes, I Agree. Please Send Me A Quote !
__________________________________________________________________
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Air Conditioning
Above Ground
Basement
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Mobile Homes
In Ground
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Home/Auto discount !