Home - Bob Meyer Insurance Lakeville, Minnesota

Minnesota Trusted Choice Insurance Professionals!

Bob Meyer and his Staff provide Auto, Home, Life, Health, & Business Insurance for Lakeville, Farmington, Eagan, Apple Valley, Burnsville, and the Greater Minneapolis/St. Paul Area of Minnesota. Representing over 20 quality insurers for the best value and choice in insurance protection.

Representing Minnesota's Leading Trusted Choice Insurers!

Home Insurance Quote Request

One Simple Form - take only 5 - 6 minutes.

Items marked with an asterisk (*) are required questions.


Your Full Legal Name:*
Property Address:*
City or Town:*
County:*
State:*
Zip Code (Postal):*
E-Mail Address:*
E-Mail (again for accuracy):*
Phone:
Fax: (optional)
Year Home Built:
Home Square Footage:
Is this Builder Risk? New Home Const.*	No Yes
Month/Year Home to be Completed if New:
Number of Units:*	1 Family Duplex (2 Family)
Foundation Type:*	Basement Slab Crawlspace over slab Other (list in remarks)
Construction Type:*	Frame Concrete Brick/Veneer Stone Other (list in remarks)
Roof Type:*	Composition Shingles Wood Shakes Tar/Gravel (Flat Roofs) Spanish Tile Metal Other (describe in remarks)
Number of Stories:*	One 1.5 Two Three
Do you own any animals or pets?*	Yes No
If last questions was yes, please describe:
Do You have a Trampoline?*	Yes No
Number of feet to nearest fire hydrant (Est) ?*	Less than 500 feet Less than 1000 feet More than 1000 feet
# of miles to responding fire department?*	Less than 5 miles More than 5 miles
Currently have home or renters insurance?*	Yes No
Prior Claims last 5 years:*	Yes (Give details in next box) No
Details of past claims:
Rate Your Credit History:*	Excellent Average Less than Average Poor
Past history of on time Insuance payments:*	Excellent Average Poor
Primary Policyholders Birth Date:
Plumbing Type in Home:*	Copper Galvanized Some Copper some Other Plastic
Heating System:*	Forced Air Gas (Propane or Natural) Hot Water (Radiators) Electric Gravity (Oil or Natural Gas)
Electrical*	Circuit Breakers Fuses
Fireplace or Wood Stove:*	None One (Wood) Two or more (Wood) One Gas Two or more Gas One or more Wood Stoves
Additional Special Features:
Monitored Alarm Security System:	Yes No
Current or Desired Dwelling Coverage:
Contents Amount:
Personal Liability Limits*	$100,000 $300,000 $500,000 $1,000,000 Not Sure
Deductible:*	$250 $500 $1000 $2500 $5000+ Not Sure
Comments/Remarks
Send my quotation via	Email Fax U.S.Mail Phone Call

Thank you for filling out this form COMPLETELY!

You should know: Agents and Insurance Companies must check your history of losses, and run your insurance score to obtain your homeowners insurance quote. Insurance scores are unique for each company with some carriers giving discounts of up to 50% for those with exceptional credit. So what is insurance scoring? Learn More!

By submitting this form, you are giving your permission.

We value your data as PRIVATE information. Every step has been taken to insure your privacy, security, and 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 for any other purpose. By submiting this form you agree to allow our agency to release this information to you and to release us from any liability should this information be accidentally viewed by others. Our intention is to maintain your complete privacy.

Bob Meyer of Miller-Hartwig Insurance. Your Trusted Choice Insurance Agent.