OREGON HOME INSURANCE

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CONTACT INFORMATION
First Name
Last Name
Address
City
State
Zip
Home Phone
Work Phone
Email
Marital Staus
Highest Level of Education
Occupation
Time at Current Residence
RESIDENCE INFORMATION
Year Built
Residence Type
Construction Type
Full Bathrooms
Half Bathrooms
Square Footage (Excluding Basement & Garage)
Finished Basement		Yes No
Roof Type
Age of Roof (Years)
Fountation
Garage Type
Number of Vehicles in Garage
Would you LIke Earthquake Coverage?		Yes No
Fire Alarm
Burglar Alarm
Current Homeowners Provider
Annual Insurance Premium
INFORMATION DISCLOSURE To offer you a quote from the companies I represent information is collected from consumer reporting agencies. This would include your driving record, claims history with other insurers, and credit report information. When you click on submit you understand this provision. PRIVACY The information that is obtained will be kept confidential, secure and will not be sold or redistributed. We don't sell our customer lists or share your information with other companies to offer their products to you.

Mark Strauss

Insurance Advisor

Office Hours:

8:30 a.m. - 5:15 p.m.

Monday to Friday

Call for a Quote:

503-296-0077

Below are a few of the reputable insurance carriers I represent: