Homeowners Insurance to Value Questionnaire

Exterior Information

Exterior walls:
 ______% to total 100%
Clapboard
Vinyl Siding
Solid Stone
Wood Siding
Stucco/Frame
Block
Wood Shakes
Brick veneer
Aluminum Siding
Stone veneer
Roofing:
 ______% to total 100%
Asphalt/Fiberglass
Clay Tile
Tin
NE Pine Shingles
Plexiglas
Wood Shake
Concrete Tile
Steel Roof
Victorian Scalloped Shake
Slate
Spanish Tile
Copper
Built Up Tar/Gravel
Rubber
Wood Shingles
Fiberglas Panel
Attached Structures:
 Indicate square footage where appropriate
Attached Garage # of Cars
Open Porch Sq.Ft.
Screened Breezeway Sq.Ft.
Redwood Deck Sq.Ft.
Built-in Garage # of Cars
Screen Porch Sq.Ft.
Closed Breezeway Sq.Ft.
Greenhouse Sq.Ft.
Carport # of Cars
Closed porch Sq.Ft.
Wood Deck Sq.Ft.
Detached Structures:
 Indicate square footage where appropriate
Garage # of Cars
Pool (above ground/built in)
Swim Pool (concrete)
Shed Sq.Ft.
Hot Tub
Special Items:
 Indicate square footage where appropriate
Atrium Windows (#)
Stained Glass 3x5 (#)
Stained Glass 5x7 (#)
Skylights 4x4 (#)
Skirting (Hillside) (#)
Picture Windows (#)
Ext. Storm Shutters (#)
Sliding Glass Doors (#)
Skylights 6x6 (#)
Bay Windows (#)
Bow Windows (#)
Atrium Doors (#)
Solar Panels (#)

Interior Information

Partitions:
 ______% to total 100%
Drywall
Plaster-Textured
Block
Drywall-Textured
Plaster-Horsehair
Brick & Block
Plaster
Studs only
Plywood only
Stone & Block
Solid Stone
Adobe
Solid Brick
Wall Coverings:
 ______% to total 100%
Paint
Glass Cloth Paper
Sheet Paneling
Millwork
Mirrors
Vinyl Wallpaper
Ceramic Tile
Solid Wood Paneling
Bookcase Walls
Foli Paper
Imported Title
Tongue Groove
Knotty Pine
Ceiling:
 ______% to total 100%
Drywall
Plaster-Textured
Tongue & Groove
Mirrors
Drywall-Textured
Acoustical
Millwork
Plaster
Wood Tin
Flooring:
 ______% to total 100%
Hardwood
Ceramic Tile
Parquet
Marble Tile
Ceramic Tile Imported
Plank
Vinyl
Carpet over Hardwood
Wall to Wall (acrylic/nylon)
Interior Items:
 Indicate Number
Fireplace
French Doors (# of doors)
Wood/Stove Pellet
Hot Tub
HVAC *
MISC. SYSTEMS *

Contact Information