Church Insurance Quote Form in Marion, Ohio

Our Associations

454 East Center Street
Marion, Ohio 43302
Tel: 740-387-4311
Fax: 740-387-5988
Email: scharer@scharerinsurance.com

Church Insurance Quote
	First & Last Name:
	Street Address:
	City, State & Zip:
	E-Mail Address:
Telephone:		Fax:

	Current Insurance Information
Insurance Company Name:
Policy Exp. Date:		Amount Insured for:
Mortgage Amt:		Premium Amt:
	Term:
Any Claims in Last 3 years?
# of floors:		Construction:
Roof type:		Age of roof:
Age of Church:		Full Baths:
1/2 Baths:		Sq. footage:
# of Buildings:		Annual Church Payroll:
# of Playgrounds/Sports Fields:
	Coverages:
Building:		Contents:
Instruments:		Occurances:
Please list any other coverages you may need:

Give any additional information that may assist us in providing you with an accurate church insurance quote:

Note: By submitting this form you understand that no coverage is bound unitl you receive written notice.