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     Billmark's Lakes Area Insurance, Inc. • 320-763-9022 • 888-763-9022      ABOUT US | CONTACT US | HOME
       
 

   
  Billmark's Lakes Area
Insurance Inc.
913 Broadway Street
Alexandria MN 56308
888-763-9022 toll free
320-763-9022 phone
320-763-3548 fax
 
 
  Lakes Area Insurance
105 Central
PO Box 567
Brandon MN 56315
320-524-2525 phone
320-834-2409 fax
  

Fill out the form below to obtain a free home insurance quote from the professionals at Billmark's Lakes Area Insurance, Inc.

Full Name:
Email:
Address:
City:
State: Zip:
Day Phone:
Evening Phone:
Fax:
Years at Current Address:
Contact Me By: Phone Email Mail Fax
Coverage on Home:
Liability Limits:
Primary Residence? Yes No
Is it Owner Occupied? Yes No
Deductible Amount:
Year Home Was Built:
Last Roof Renovation: (year)
Last Wiring Update: (year)
Last Plumbing Update: (year)
Number of Miles to Nearest Fire Department:
Responding Fire Department:
Type of Heat:
Last Heat Update/Installation: (year)
Any free standing wood burners? Yes No
Is home within city limits? Yes No
Are there any detached structures? Yes No
Are there any pets or animals on premises? Yes No
    If yes, please list types:
Do you own a trampoline? Yes No
Is there any business or daycare done from this home? Yes No
Any losses in the last three (3) years? Yes No
    If yes, please detail losses:
Additional comments:

 

 
     
 


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