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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Resorts, Hotel and Motel
Insurance Quote Form
One Simple Form - takes only 2-3 Minutes!
 
Your Name:
Business Name:
Property Address:
City:
State: (Must be California)
Zip/Postal:
E-Mail (REQUIRED):
E-Mail
(again for accuracy):
Phone:
Fax (optional):
 
 
Dwelling Information
 
Year Facility Built:
Square footage/Acreage:
Describe Facility and
Ammenities in Detail:
Gross Annual Income: $
 
Occupancy: Owner Tenant
 
Type foundation: Slab
Crawlspace over slab
Pier & Post
 Other (list in remarks)
 
Type finished basement, if any: None Full
25% 50% 75%
 
Type Roof: Shingle Wood Shake
 Tar/Gravel Spanish Tile Metal Other
 
Type of Siding Brick   Vinyl
Wood   Aluminum
 
Number of stories: One Two
Three 4 or more
 
# 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)
 
Describe Swimming, Camping, and Any Other Recreational Facilities on Premises in Detail:

 
Coverages:
 
Building(s) Cov. $ Contents $
Liability Cov. $ Deductible $
($250, $500, $1,000, etc.)
 
Other Coverage/Remarks
(describe any extra coverages needed such as business interruption, robbery, computers, etc.):
 
Send my quotation via: E-Mail Fax
Regular Mail
Call Me by Phone
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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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