Request a condo insurance quote covering your interior, belongings and liability. Independent agency in Los Angeles comparing multiple carriers; a licensed agent reviews every request.

1. First Name (required)
2. Last Name (required)
3. Cell Phone (required)
4. Email (required)
5. How did you find us? (required; choices: Search engines / Social media / News story / Referral / I am a current client of Susman Insurance)
6. Name of Referral (required; only when applicable)
7. Are you working with one of our Agents? (required; choices: Yes / No)
8. Agent’s name (required; only when applicable)
9. Street Address (required)
10. City (required)
11. State (required)
12. ZIP Code (required)
13. Have you had any claims in the last 5 years? (required; choices: Yes / No)
14. Date of loss and cause of loss (optional)
15. What is the occupancy? (required; choices: Owner Occupied / Tenant Occupied / Vacant)
16. Home year built (required)
17. Home square footage (required)
18. Water leak detection? (required; choices: No / Valve Closure / Central Monitor / Valve Closure with Central Monitor)
19. Amount of personal property? (required; choices: $25,000 / $50,000 / $75,000 / $100,000 / $250,000 / $500,000)
20. Do you have any personal property of specific value to insure? (required; choices: Yes / No)
21. What is it? (required; only when applicable)
22. Inside Improvements Coverage (optional)
23. How will title be held (insured names, trust, LLC?) (required)
24. Date of system update: Plumbing (optional; date)
25. Date of system update: Roof (optional; date)
26. Date of system update: Electrical (optional; date)
27. Date of system update: Heating (optional; date)
28. Date of Birth (required; date)
29. Occupation (optional)
30. Address (required)
31. Address line 2 (optional)
32. City/Town (required)
33. State/Region/Province (required)
34. Zip/Post Code (required)
35. Country (optional)
36. Are you in escrow? (required; choices: Yes / No)
37. Will you be moving in within 30 days? (required; choices: Yes / No; only when applicable)
38. Please explain why you will not be moving in within 30 days. (required; only when applicable)
39. Purchase date (optional; date)
40. Pets (optional)
41. Alarms (optional)
42. Is there a pool? (optional; choices: Yes / No)
43. Is pool or yard fenced? (optional; choices: Yes / No; only when applicable)
44. Security bldg. (optional)
45. Guard or gates (optional)
46. # of units in bldg. (optional)
47. List of pets. What breed are they? (optional)
48. Do they have a biting history? (optional; choices: Yes / No)
49. Do you want EQ? (optional)
50. Do you want multi policy? (optional)
51. Also quote the following (required; choices: Earthquake insurance / Flood insurance / Mortgage protection insurance / Other / None)
52. Interior sprinkler system? (optional)
53. Currently insured? If so which carrier? (optional)
54. Is your policy currently being non-renewed? (required; choices: Yes / No)
55. Reason for non-renewal (required; only when applicable)

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