Vincent F. Gauci - VFG Associates,LLC

VFG Associates, LLC

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Call 734-855-4930
or 800-859-4453
Fax 734-855-4933
29432 Joy Road, Livonia, MI 4815

Request Form

Homeowners Quote Request

Please remember: We cannot bind coverage from an email request. Coverage is bound after you receive a written email or telephone confirmation from an agency staff member.

Please Select your preferred agent.
Agent:
Effective Date:
Your Name: D.O.B. 
Your Mailing Address: Street

City, State & Zip
    
Your Occupation: 
E-mail Address: 
Daytime Phone: 
Prior Address:
(If less than 2yrs at
current address)
Street

City, State & Zip
    
Any Associations or Groups memberships which are eligible for
premium discounts? 
If yes, please list here:  
Choose One:  Please call me with quote premium.
 Please send quote via e-mail.
 
Current coverage: Company:
 
 Expiration Date:
 Coverage Amount:
Type of policy desired:  
Amount of insurance desired:
Homeowners:  Condo/Renters: 
Current value of your home: Current value of your personal property:
 
Both Homeowners and Condo/Renters:  
Liability Limit:   
Medical Payments:  
Deductible:  
Property Information:  
Construction Type:  Year built: 
Distance to the nearest fire hydrant:  Number of Stories: 
In what County/Township are you located?  Number of Full Baths:    Number of Half Baths:
Ground floor squre footage:   Total square footage: Fireplace  Yes No
Basement Unfinished Finished -  Percent finished: Central Air  Yes No
Crawlspace      Slab Garage:
Porch     If yes, total square footage: Swimming pool:  Yes No
What kind of pets do you have?  Do you have a trampoline?  Yes No
Smoke Detector(s) Installed
Home Security System Installed
Do you use a wood burner?  Yes No

 
Home Updates:  Enter year updates were made. If year not known, enter "unknown":
Roof:

Wiring:
Plumbing:

Heating:
Optional Property Coverages: Property Floaters - Indicate limits below: Other Floater Coverage:
Earthquake Coverage
Flood Coverage
Sewer/Water Backup Coverage
Antiques:   Furs:  Type Limit
Coins:   Jewelry: 
Computers:   Stamps: 
Fine Arts:   Tools:   
Previous Loss Information
Please describe any losses or claims filed on your Homeowners Insurance in the last 3 years. Include the date, type of loss and the amount of the claim.
Additional Comments
Please use the box below to enter any additional information you wish to include:

Protecting your privacy and identity is very important to us. 
Your Social Security and drivers license number may be required to complete this quote.   Please be sure you have provided an accurate contact number so that we can contact you personally for this information.


If you have not received a response from us within one business day, please contact us again. Thank you.

Securities Offered Through KCD Financial,Inc. Member FINRA & SIPC, 3313 S. Packerland Drive, Suite E, DePere, WI 54115