Let's start here...Who might you be? *Realtor® working to help a clientNew, potential customerExisting customer looking to do more with ArcherWhat type of Insurance do you need? *Personal InsuranceCondo Master InsuranceBusiness InsuranceCommercial Property InsuranceIf you need both, business insurance & personal insurance, please do them separately. Thank you! Customer Name *FirstLastCustomer 2 NameFirstLastBusiness Name *Customer contact name *Customer phone # *Customer email address *How did you hear about Archer Insurance? *My Realtor®My mortgage professionalMy Market CenterOther...Keller Williams®? *YesNoWhich Keller Williams® office? *Realtor® name? *Name of the person who referred you? *We'd love to thank them!Let us know where/how you heard of us! *We'd love to know, and to say "Thanks!" if an individual.What kind(s) of personal insurance can we quote for you? *For MAX SAVINGS, Bundle home & auto!Home: Homeowner's, Apartment, OR Condo Unit Owner'sAuto insuranceOther types of personal insuranceGreat! Let's start with the home quote. Is this a purchase? OR, are we quoting to save money on an existing policy? *PurchaseQuoting to save moneyCustomer 1 date of birth *Customer 2 date of birth (if any)You can leave this blank if only one customerIs this a condo? *YesNoCan you upload a copy of the association's bi-laws? *YesNoSend link to do this later....Condo association bi-laws UPLOAD: *The easiest way to quote this is to upload a copy of the existing insurance policy. Do you have a PDF copy handy? *YesNoSend link to do this later....While we can work without a copy, the process really is easier if you shoot us a copy. Current HO Dec Page OR Policy UPLOAD: *Ok. No sweat. How many units/families? *1 unit2 units3 units4 units5 OR more unitsEasy stuff...Will the owner live in the property? OR all tenants? *Yes, owner occupiedNo. Owner won't live there.Any initial period of building vacancy? *No. It's occupied OR will be right after policy effective date.Yes. Will be vacant for a bit. Tell us how long you think it will be vacant for *less than 1 month1-3 months3-6 months6 months-1 yearAny work to be done on the property? *YesNoDescribe the work to be done. *Tell us roughly what you'll do, approximate budget for the project, who's doing the work, etc...What is the customer's current residential address? *Address Line 1Citytype state...AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeIs the address to be insured the same? *YesNoSince you indicated that this was a purchase, and already live there, can you explain this a bit? *Sometimes this is due to someone buying a family home, buying a rent-to-own property, etc. It's not a problem. Just let us know how these two co-exist. What is the address to be insured? *Address Line 1Citytype state...AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeThis is where you indicate the address of the property we'll insure.Anticipated closing date? *Feel free to type "I don't know" if a ways away...Do you have any questions or concerns you want to share about homeowner's insurance? *Yes. I do.No. I'm good.Whatcha got? We're happy to help! *Just blurt out all that's on your mind. We'll sweep in and answer anything you throw at us. Ok. Great. Let's do the auto real quick! You buying a new vehicle OR we quoting an auto you already own/trying to save money? *Existing Auto Policy/ Save me money!Purchasing Vehicle / From scratch...Let's see what we can do! Can you upload a copy of the current auto policy? SO MUCH EASIER! *Yes.NoSend link to do this later....Auto Policy/Declarations UPLOAD: *To be sure, how many drivers currently? *12345Upload copy of Driver #1's licenseThough better now, it is ok if you send this to us later...Upload copy of Driver #2's licenseThough better now, it is ok if you send this to us later...Upload copy of Driver #3's licenseThough better now, it is ok if you send this to us later...Upload copy of Driver #4's licenseThough better now, it is ok if you send this to us later...Upload copy of Driver #5's licenseThough better now, it is ok if you send this to us later...How many vehicles? *12345VIN or Plate # of Vehicle #1 *Type, letting us know if you don't have it for some reason...VIN or Plate # of Vehicle #2 *Type, letting us know if you don't have it for some reason...VIN or Plate # of Vehicle #3 *Type, letting us know if you don't have it for some reason...VIN or Plate # of Vehicle #4 *Type, letting us know if you don't have it for some reason...VIN or Plate # of Vehicle #5 *Type, letting us know if you don't have it for some reason...Is this a private sale? OR, are you buying from a dealership? *Personal SaleDealershipName Dealership, phone number, and name of your contact there?Let us know who you're buying the vehicle from. Family member, friend, online, etc?Is the customer a AAA member? *YesNoAAA members receive additional discountsCan you upload a picture of the AAA card? *YesNoIt is ok to send this to us later if not easy for you now.Upload copy of the AAA card. *What kind of business insurance do you need? *General LiabilityWorker's CompCommercial AutoErrors & Commissions (E&O/Malpractice)Commercial PropertyOtherIf you need more than one kind of business insurance, please do each of them separately. What kind of insurance are you looking for? *Can you upload a copy of your current policy? SIMPLIFIES PROCESS! *YesNoSend link to do this later....Please read the below disclaimer and sign here... *Clear SignatureArcher Insurance is an independent insurance broker licensed in all New England States with a primary office situated in the Commonwealth of Massachusetts. Archer Insurance and Keller Williams are independent entities. Archer Insurance and some Keller Williams offices are party to agreements pursuant to which commissions on insurance customer accounts may be shared. These agreements do not increase or in any other way affect premiums should you elect to place your insurance coverage through Archer Insurance.EmailSubmit to the Archer Team