• Home
  • Get a Quote
    • Homeowner's Quote in 24 Hours
    • Builder's Risk
    • Business & Commercial
    • Farm & Ranch
    • Homeowners & Auto
    • Life
    • Renters Insurance Quote
    • Student-Accident Quote Form
  • Customer Service
    • Personal Lines Customer Service
    • Commercial Lines Customer Service
    • Certificate Request Form
    • Family Risk Questionnaire (FRQ)
    • Small Business Questionnaire (SBQ)
  • 24/7 Portal
  • Make a Payment
  • Resources
    • Secure Area
    • A.M. Best Rating & Financial Size Categories
    • Compensation Disclaimer
    • Small Business Questionnaire (SBQ) - Austin
    • Private Client - New Customer Discovery
    • Dwelling
    • Vehicles
    • Liability
    • Collectibles
    • Flood-Earthquake
    • Watercraft
    • Insurance Glossary
  • About Us
    • Our Locations
    • Employee Directory
    • Testimonials
    • SMS/Text Messaging Terms & Conditions
    • Privacy Policy
Logo
Home > Homeowners > Liability
Secured by SSL

Liability


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.

Primary Insured
First Name *
Last Name *
Street *
City *
State / Province *
ZIP / Postal Code *
Primary Phone Number *
E-Mail Address *
Date of Birth *
/ /
Occupation *
Driver License Number *
Spouse Information
Name (First and Last) *
Date of Birth *
/ /
Occupation *
E-Mail Address *
Phone Number
Driver License Number *
Child(ren) Information
Do you have children at home who drive?

If yes, please provide the following for each child: Name; DOB; Driver License #
Umbrella
Amount Needed to Protect Assets
Liability Limit Needed
Uninsured/Underinsured Limits Needed
Personal Property Information
Number of personal residences insured under Homeowner's policy or dwelling form
Number of rental insured under Homeowner's policy or dwelling form
Number of acres - Rural vacant land
Number of acres - Urban vacant land
Personal Automobiles Information
What is the current liability limits on you existing auto policy?
Number of autos you maintain
Number of motorcycles you maintain
Number of drivers
Number of drivers over 89 years
Number of drivers with a major violation within last 5 years
Watercraft/Unlicensed Vehicles/Jet Skis
What are the current liability limits on your existing policy
Number of boats under 27 feet and under 45 MPH
Number of boats over 27 feet with max speed 45 MPH (yachts, sailboats)
Number of boats under 42 feet and between 45-60 MPH
Number of golf carts
Number of jet skis with speed under 55 MPH
Number of ATVs, snowmobiles, Mules
Business Property
Number of Habitational Units
Number of Swimming Pools
Square Feet of Professional & Service Offices
Business Automobiles
Number of private passenger autos
Number of pickups 1/2 ton to 1 ton
Number of non-owned autos
Number of drivers with a major violation within last 5 years
Submission Validation
Required

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.
Secured by SSL
Insurance Websites Designed and Hosted by Insurance Website Builder
Social Social
14285 Midway Road, Suite 100, Addison, TX 75001
Phone: 214-301-3333 | 698.info@bbrown.com 
Make a Payment


Legal Notice │ Privacy Statement

Powered by Insurance Website Builder