State of Maine
Homeowners Insurance
Online Quote Request

A service of Blake, Hall & Sprague Insurance
170 Ocean Street South Portland, ME  04116-2403 (207)799-5541

Please provide the information below to receive a
Homeowners Insurance Quotation.
This service is currently available only for properties in the State of Maine.

We will email your quote, usually within one business day.
Submit as many optional quote requests as you would like.

To ensure accuracy, and to reduce your entry time,
please have your current policy in front of you.

General Information

Name:

Address:

City, (State of Maine Only), ZIP:

Phone #:

Home

Work

email address:

Coverage Information

(Having your current insurance policy in front of you will greatly reduce the time it takes to complete this form.)

Name of your current insurance company:

Policy expiration date:

Use of the property:

Current Amount of Insurance
On Dwelling
("Coverage A" on  your policy):

$

Current Amount of Liability Insurance
("Coverage E" on  your policy):

Property Deductible:

About Your Home:

What year was your home built:

Construction Type:

Please provide the year that the following systems were last fully updated:

Roof:

Plumbing:

Heating:

Electrical:

Water Source:

Closest Fire Station:

Discounts and Other Information:

Have you made any homeowners claims in the last three years?
(e.g. theft, water damage, wind, liability)

Yes

No

If "yes", please provide
details in "remarks" below.

Does anyone in the household smoke?

Yes

No

Fire Detection Device:

Burglar Alarm:

Dog(s)

Do you have any of the following?
(Please check all that apply, and provide details in "remarks" below)

Woodstove

Trampoline

Name of your employer(s):

Yes

No

Is any business conducted
on the property?

If "yes", please provide details in "remarks" below.

Optional Coverages:
(Select as many as you desire)

Replacement Cost Contents

Guaranteed Replacement Cost for Dwelling
(may not be available for homes over 40 years old)

Scheduled Personal Property:
(select type of property and indicate total value in remarks" below.)

Jewelry

Fine Arts

Silverware

Firearms

Furs

Computers

REMARKS:

BH&S Home Page

Quote Other Insurance

© Blake, Hall & Sprague, Inc
170 Ocean Street 
South Portland, ME  04116-2403 
(207) 799-5541    (800) 373-5541
Maine Resident Producer Agency #AGR29506