Webb Young Webb Liles Tolentino
3007 NW 63 Ste 130
Oklahoma City, Oklahoma 73116

Phone: 405-843-9481
Fax: 405-848-8417

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Condominium Owner & Owners Insurance Quote
	First & Last Name:
	Location Street Address:
	City, State & Zip:
	E-Mail Address:
Telephone:		Fax:
	Business Name:
Insurance Company Name:
	Policy Exp. Date:
Any Claims in Last 3 years?   (if Yes, please describe)
Do you carry work comp for your managers?			Yes No
	Year Property Built:
Any Updates to Property?   (if Yes, please describe)
Complete Lender Info.   ie Escrow Info if new purchase
	Condo Information
Number of Units:		How many Stories?:
# of buildings:		Flood Insurance?	Yes No
Any Pools?	Yes No	Construction Type:
Total Sq. Ft. of building (s):
Earthquake Insurance?		Yes No
(if Yes, what type of parking?)
How did you hear about us?		Select Referral Internet Search Google Yahoo Bing Flyer/Brochure Phone Book Radio Spot Other
Please give any additional information that might be helpful in providing you an accurate apartment owners insurance quote:
Note: By submitting this form you understand that no coverage is bound until you receive written notice. You also agree to release us from any liability if this information is accidentally viewed by unauthorized persons. We will only use this information for insurance quoting purposes and not distribute to other parties.

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