Builder's Risk Quote

Fill out the following form as completely as possible. Once you have completed the form, click the Submit button to send your information. Your request will be handled promptly.

First Name

Required

Last Name

Required

Named Insured

Required

Street Address/Mailing Address

Required

City

Required

State

Required

ZIP / Postal Code

Required

Primary Phone Number

Required

E-Mail Address

Required

Legal Name of Builder (include entity type)

Required

Builder's Address/City/State/Zip

Required

Builder's years in business

Required

Builder's years' experience

Required

Applicant is

Required

Type of Risk

Required

Risk Address (address/city/state/zip) Must Include Zip Code

Required

Total Cost of Construction (not including land)

Required

Project Start Date

Required

Project End Date

Required

Type of Construction (frame, joisted masonry, etc)

Required

Number of Stories

Required

Square Footage

Required

Deductible ($1,000; $2,500; $5,000; other)

Required

Protective Measures (fencing, lighting, security, etc.)

Required

Any BR claims in the last 5 years?

Required

Is profit included in the construction values?

Required

Complete this section if project is a remodel/renovation:

Coverage needed for existing structure?

Optional

Any structural work?

Optional

If "yes" to structural work, please describe

Optional

Are there changes to the roof line?

Optional

Actual Cash value of existing structure

Optional

Replacement Cost value of renovations

Optional

Provide thorough description of renovations, including details of any structural work

Optional

Submission Validation

Required

Enter the Validation Code from above.

Important Notice
Any submissions or payments made via this website do not constitute a binding agreement to your policy or coverages. Changes and payments to policies are not effective or binding until you, or any party involved, receive official notice from either your insurance agent, or your insurance company. If you have any questions, please feel free to contact us.

Per the terms of our online privacy policy we will not resell your information to any third-party.

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Phone: 214-301-3333 | Fax: 972-664-1977 | info@brookstone-group.com