California insurance from High Sierra Insurance Agency
Meeting the Business and Personal Insurance Needs of California Residents & Businesses!

Commercial and Businessowners Insurance from High Sierra Insurance.com
Workers Compensation

General Liability Insurance

Contractor Programs

Resorts/Motels/Campgrounds

Commercial Auto Insurance

Professional Liability Ins.

Employment Practice Liability


Personal Auto, Homeowners Insurance from High Sierra Insurance.com
Personal Auto Insurance

Homeowners Insurance

Renters Insurance

Recreational Vehicle

Boat/Jet Ski Insurance


Life and Health Insurance Products from High Sierra Insurance.com
Individual Life Insurance

Individual Health Insurance

Group Health Insurance

Medicare Supplements


Other Insurance Services from High Sierra Insurance.com
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On-Line Renters
Insurance Quote Form
One Simple Form - takes only 2-3 Minutes!
Your Personal Data:
 
Your Name:
Property Address:
City:
State: (Must be California)
Zip/Postal:
E-Mail (REQUIRED):
E-Mail (again for accuracy):
Phone:
Fax (optional):
 
Dwelling Information
 
Year Dwelling Built:
Home Square footage:
 
# Units in common bldg.:
 
Type Roof: Shingle Wood Shake
Tar/Gravel Spanish Tile
 
Number of stories: One Two
Three 4+
 
Do you own animals or pets? Yes No
If yes, list type/for dogs, list breed:
 
Are You Near Brush Area? Yes No
 
# of feet to nearest
fire hydrant: 		# of miles to nearest
fire station:
 
Currently Insured? Yes No
Name of Carrier & how long insured?
 
Prior Claims? Yes No
Describe claims in detail:
 
Plumbing type: Copper Galvanized
Mixed (Copper/Galvanized)
 
Circuit Breakers or fuses? Breakers Fuses


# Fireplaces: # Chimneys:
 
Special features
(i.e., deck, air conditioning, alarm systems, pool, etc.)
 
Coverages:
 
Contents $ Loss of Use $
Liability Cov. $ Deductible $
($250, $500, $1,000, etc.)
 
Comments/Remarks
(describe any scheduled jewelry, in-home business, or other special coverages needed here):
 
Send my quotation via: E-Mail Fax
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We value your input as PRIVATE information. Every step has been taken to insure your privacy, security, and our intent is to release quote information only to you. We will not give your data to ANY other person or group for sales, marketing, or ANY other purposes. By checking the box below you agree to allow our agency to release this information via the method you have chosen, and to release us from any liability should this information be accidentally viewed by others. Our intention is to maintain your complete privacy.

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High Sierra InsuranceServices, . PO Box 1119 . Chester, CA 96020 . CA Insurance License #0573654
Phone: 530-258-3477 | Fax: 530-258-2607 | E-Mail us at: quotes@highsierrainsurance.com
Our Telephone Quoting Hours are: 8:00am to 5:00pm (Monday-Friday) | View Our Privacy Notice
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