Make your own free website on Tripod.com

Your Name:
Address:
Your E-mail Address:
Your telephone number:

 Would you like to insure your buildings?
If yes, Please specify the value:

Would you like to insure your contents?
If yes, Please specify the value:

Would you like to insure your valuables on an All Risk Basis?
If yes, Please specify the total amount of valuables:
 
Would you like to be covered in case of an earthquake? Yes   No
Do you have a a motor insurance policy with SOVAG? Yes   No
 
Is your house protected with a burglar alarm? Yes   No
Are you a holder of Karta Anzjan? Yes   No

 

Is your house unoccupied for more than 30 days in any one year ?
If yes, please specify number of days
Yes   No

How would you like to receive your quotation?
  Post
  E-Mail
 

After submitting the quotation you will return to our Home Page.