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Jeff Webb
281-970-0730

 
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Insurance - Request A Quote

Yvette Pitts
Farmers Insurance and Financial Services Agent

20111 Fm 2100 Rd. Ste 226
Crosby, TX 77532-3716

Phone: (281) 324-6265
Fax: (281) 324-6257
ypitts@farmersagent.com



Request A Quote
Please take a moment to fill out the form below.   If you have any questions please call Yvette at 281-324-6265.

Name: Spouse:
Home Phone:       Cell/Work Phone:
Address
City , County:, Zip:
 
Note: If you are not comfortable giving your SS# and DOB, we will be happy to call you for it.
Caller SSN:   TDL:   Date of Birth:
Spouse SSN:   TDL:   Date of Birth:
 
Fire Station:   Fire Hydrant Ft?  Dist. to local fire dept:miles.
Home:  Yr Built:  Total Square Feet:  Roof Age:yrs.
   Roof Type:
Exterior Construction  % Brick Veneer:  Hardi-plank:  Stone Veneer:
  Siding  (Wood/Aluminum/Vinyl):  Style:
   Garage:  # of cars:  Built-in  None Carport
Interior  Interior Walls %  Paint:   Wallpaper:   Paneling:
   Wall Heights %  8ft:   9ft:   10ft:   Cathedral:
   Flooring %   Carpet:   Vinyl:   Tile:   Wood:  
 Laminate:   Other:
   Kitchen Grade:
   Full Baths: Economy#:   Standard#:   Custom#:
 Half Baths#:
   Plumbing Type:
   
   Central Heat & AC:  Heater:
   Fireplace#: 
   Breezeway:   Deck:   Porch:
   
Extra Features:  Sauna  Solar Panels  Stained Glass  Central Vacuum:
   Electrostatic Air Cleaner  Greenhouse  Fire Sprinklers  Spiral Staircase:
   Indoor BBQ  Intercom System  Trash Compactor  Additional Furnace:
   
Enter Quantity:  Skylights:   Exterior Shutters:   Inter Shutters:
   Wet bar:   Jacuzzi/Hot Tub:
   
Discounts:  Monitored Alarm   Auto/Home/NonSmoker   50+
   Quality Roof   Hail Resistant Roof   Home Security    Life
   

 

 

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