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Prefer to talk to a person? Call 516‑579‑8700 and ask for Charles — I’m happy to quote you over the phone.

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Family owned and operated for over 55 years! We take pride in how quick and easy it is to reach us everyday!

Contact Information

First name *

Last name *

Email *

Mobile phone *

Primary address (street, city, state, ZIP) *

Preferred contact *

Date of birth *

How did you hear about me?

This driver is me (auto‑fill from Contact Information)

Driver full name *

Date of birth *

Driver’s license # (optional)

Relation to primary (optional)

Add one or more vehicles. VIN is optional but helps speed things up.

Year *

Make *

Model *

VIN (optional)

Primary driver name

Property address *

Same as primary address entered

Occupied by *

Year built

Approx square footage

Roof year (if known)

Any prior home claims?

Anything else I should know?