Insuring Your Bed & Breakfast 8040 W. Hwy. 50 - Salida, Colorado, 81201 (719)539-0144 - (800)571-2026 - Fax (719)539-4696 Please Feel Free to Contact Us, Should You Have Any Questions.
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Name
Phone Number
Fax Number
E-Mail
Preferred Contact Method
Address
County
State	Click to Select Arizona California Colorado Iowa Kansas Missouri Nebraska New Mexico Oklahoma Texas
Zip Code
Year Home Was Built
Type of House	Click to Select single story one & one half story two story three story more than three story tri/bi-level
Type of Construction	Click to Select brick frame manufactured 1/2 &1/2
Square Footage (not including basement)
Type of Roof	Click to Select asphalt wood shake tile metal fiberglass

Basement	yes	no	% finished
Fireplace	yes	no	how many	type
Deck	yes	no	square feet
Air Conditioner	yes	no
Swamp Cooler	yes	no
Garage	yes	no	number of cars
Attached Garage	yes	no
Central Alarm	yes	no
Smoke Alarm	yes	no
Fire Extinguisher	yes	no
Dead Bolts	yes	no
Animals	yes	no	type & number
ANY Losses	yes	no	Type of Loss
Bankruptcy or Credit Problems	yes	no
Purchase Price			$
Date of Closing
Current Policy Expires
Current Coverage Amount			$