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Kraft Lake Program Guidelines:Primary dwelling value $1,000,000 or greater for risks outside of California. Risks with loss history may not be acceptable and are subject to underwriting approval to quote.

* means required field

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

If Retired List Prior Occupation:

 
Is this a new purchase?
 
 
Has policy been non-renewed?

HOMEOWNERS QUOTE SHEET

You must be a Kraft Lake agent to Request a Quote. Please include your agency name and producer number prior to submission for a quote to be processed. If this information is not included or is not valid, the quote will not be processed.

Kraft Lake Program Guidelines:• Primary dwelling value: $3,000,000 or greater. Risks with loss history may not be acceptable and are subject to underwriting approval to quote
• Primary dwelling values below $2,000,000 will not be considered.
• Primary dwelling values between $2,000,000 and $3,000,000 will be considered with a Farmers declination. Please send declination to kraftlake@chubb.com after submitting the online homeowner application.

Do you want to fill all required fields of HOMEOWNERS QUOTE?
Type of Dwelling:
 
Is the home currently under Renovation or Construction?
 

Special Note: Quote cannot be released until 30 days of estimated completion date.

If NO, are there any plans for renovation or construction within the next twelve months?
 
Inservant:
(Hours worked 20 or more)
Outservant:
(Hours worked 10 or more)

Texas Deductibles

Wind and Hail - Choose either a flat or % deductible option

All Other Perils - Choose either a flat or % deductible option

Is this the Primary Residence:
Is this a Secondary Residence:

Secondary Residence cannot be written without a qualifying primary home.

If Yes to Secondary, is it Rented to Others:
 
 
 

California Homes

If home was built before 1945, has it been retrofitted?
 
Is earthquake coverage desired?
Finished Basement:

PROTECTION:Homes must be within 1,000 feet of a fire hydrant and within 5 miles of a fire station to qualify for our preferred rates.

Within 5 Miles From Fire Department:
Within 1,000 Feet From Hydrant:
Burglar Alarm: Central Station
Fire Alarm: Central Station:
Sprinkler System:
Monitored Water Flow Alarm:
Gated Community:
Guarded Community:
 
 

MORTGAGE INFORMATION:

Is there a mortgage?

Homeowner Loss History:

Have there been any homeowner losses within the last 5 years?
Was it a CAT loss?

VALUABLE ARTICLE QUOTE SHEET
Jewelry: # of Items: Itemized Amt: Blanket Amt:
In-Vault: # of Items: Itemized Amt: Blanket Amt:
Furs: # of Items: Itemized Amt: Blanket Amt:
Fine Arts: # of Items: Itemized Amt: Blanket Amt:
Collectibles: # of Items: Itemized Amt: Blanket Amt:
Collectibles: # of Items: Itemized Amt: Blanket Amt:
Silverware: # of Items: Itemized Amt: Blanket Amt:
Cameras: # of Items: Itemized Amt: Blanket Amt:
Other-Misc: # of Items: Itemized Amt: Blanket Amt:
Other-Misc: # of Items: Itemized Amt: Blanket Amt:

Valuable Article Loss History:

Have there been any valuable article losses within the last 5 years?

EXCESS LIABILITY QUOTE SHEET
 
 

# OF RESIDENCES:

If more than 4 residences, list in comment section at end of form


AUTOMOBILE QUOTE SHEET
Do you want to fill all required fields of AUTOMOBILE QUOTE?
Does client have a Corporate Car?

DRIVERS

* Driver Name * Date of Birth * License# * Vehicle#
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VEHICLES

* Year * Make * Model
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Accident, Violation, Loss History:

Have there been any auto accidents, violations or losses within the last 5 years?

NUMBER OF WATERCRAFT:

YEAR MAKE MODEL LENGTH HP/SPEED
         
         
         
         

Watercraft Accident, Violation, Loss History:

Have there been any watercraft accidents, violations or losses within the last 5 years?

If more than 4 watercraft, list in comment section at end of form