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PENNSYLVANIA & NEW JERSEY:
  • Auto Insurance

  • Homeowners Insurance

  • Coastal Property Insurance

  • Personal Umbrella Insurance

    COVERAGE IN ALL STATES:

  • Contractor Insurance Quotes

  • General Liability Quotes

  • Businessowners Insurance

  • Professional Liability / E&O

  • Commercial Property

  • Commercial Auto Insurance

  • Limousine Insurance

  • Workers Comp Quote

  • Life Insurance Quotes

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    • On-Line Personal Umbrella
    Insurance Quote Form
    One Simple Form - takes only 2-3 Minutes!
    Your Personal Data

    Your Name:
    Property Address:
    City:
    State:
    Zip/Postal:
    E-Mail (REQUIRED):
    E-Mail Again (for accuracy):
    Phone:
    Fax (optional):
     
    Umbrella coverage gives you a layer of liability coverage above your auto, homeowners, rental dwelling coverage, and RV (cycle, motor home, etc.), up to the limit you select. Standard policy is a $1 Million liability limit; but we also have policies available at $2 Million and $5 Million. Fill in ALL fields below:
     
    Dwelling Information

    # of dwellings you own and occupy (INCLUDING your home):
     
    total UNIT count of all rental dwellings    (NOT including units you own and occupy):
     
    Number of Automobiles you own (Describe Yr, Make & Model of each:
     
    Number of RV's you own:   (Include boats, RV's, motorcycles, motorhomes, etc.)
     
    Vehicle Operator's Information

    Number of Drivers: 1 2
    3 4 or more
     
    List AGES of all drivers:   (Include all children and household members.)
     
    Driving Records Clear?   (If not, list all cites and accidents per driver.)
     
    Coverage Information

    Limit of Coverage: $1 Million
    $2 Million
    $5 Million
     
    Underlying Auto Limits: $100/300/50
    $250/500/100
    $300,000 CSL
    $500,000 CSL
     
    Underlying Homeowner Limits: $300,000
    $500,000
     
    Underlying Rental Dwelling Limits:  (Rentals must have $500,000 liability INCLUDING Personal Injury coverages) $500,000 incl. P/I
    Other (not acceptable)
     
    Currently Insured? Yes No
    Name of Carrier & how long insured?
     
    Prior Claims? Yes No
    Describe claims in detail:
     

    Comments/Remarks:
     
    Send my quotation via: E-Mail
    Telephone - please call
     Fax
    Regular Mail

    Thank you for filling out this form COMPLETELY!

    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 them from any liability should this information be accidentally viewed by others. Our intention is to maintain your complete privacy.

    Yes, I Agree. Please Send Me a Quote NOW!

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    Thank you for visiting the insurance web site of Citizens Comprehensive Insurance, LLC)
    505 Old York Road, Suite 105 - Jenkintown, PA 19046    (Click for Map/Directions)
    Phone: 215-254-7200    |    Fax: 215-572-7192    |    Privacy Notice/Copyright Info.
    E-Mail: quotes@citizenscompins.com   |   More About our Agency's Services   |    © 2008 Insurance-Web-Sales
    Questions or web site-related problems, please E-mail us at: quotes@citizenscompins.com