1234567 This field is hidden when viewing the formUntitledThis field is hidden when viewing the formUntitledThis field is hidden when viewing the formUntitled Yes No This field is hidden when viewing the formCreate or Retrieve QuoteNew QuoteRetreieve QuoteQuote Start a new Quote Retrieve a Quote/Pay Policy Percentage Comic Books $ Sports Memorabilia $ Art $ Advertising $ Guns and hunting accessories $ Antique Radios $ Antiques $ Dolls $ Trading Cards $ Gold and platinum coins $ Coin Operated Devices $ Entertainment $ Furniture $ Stamps $ Glass And Pottery $ Hunting And Fishing $ Toys and Action Figures $ Musical Instruments $ Vintage Sewing $ Western Americana $ Writing Instruments $ Zippo Lighters $ Other $ Collection TypeMore Collections Total Collection Value Other types Other Collections to insure: Comics Art Sports AdvertisingCollectibles AntiqueRadios AntiqueTools Dolls CoinOperatedDevices Entertainment Furniture GlassAndPottery HuntingAndFishing LimitedEditionItems MusicalInstruments VintageSewing WesternAmericana Whiskey Wine WritingInstruments ZippoLighters Other of collections you can insure and exclusions exclusions Government seizure or destruction of property War and nuclear hazards Gradual deterioration such as fading, creasing or denting Nesting, infestation or discharge or release of waste products or secretions by insects, rodents or other animals Dampness or dryness of atmosphere Changes in or extremes of temperature other than fire Fraudulent, dishonest or criminal acts Voluntary parting with covered property Loss or damage while being worked on by you or others working on your behalf Mysterious disappearance This is not a complete list of exclusions and exclusions can vary by policy. to our coverage. This field is hidden when viewing the formDo you have gold or platinum coins? Yes No Do you have any individual items over $25,000 USD in value? Yes No This field is hidden when viewing the formUntitledThis field is hidden when viewing the formUntitledEmailForumMsgBoardReturningCustomerExistingCustomerMagazineNewsLtrAgentOnlineAdOnlineSearchReferredByAppraiserReferredByAssociationReferredByAuctionHouseReferredByCustomerReferredByDealerShowBindingAgentOtherYour informationsFirst Name*Last Name*Phone*Email Address* Address Enter the address or postal code of your residence Don’t see your address? Click here. Address Line 1 Address Line 2 City StateAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDistrict of ColumbiaDelawareFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming Zip Code Is your collection stored at the same address? Yes No Alternative Address Enter the address or postal code of your residence Don’t see your address? Click here. Address Line 1 Address Line 2 City StateAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDistrict of ColumbiaDelawareFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming Zip Code This field is hidden when viewing the formUntitled Tell us if your collection is using any of the following safeguards* I don’t have any safeguards Smoke Alarm Central Station Alarm Safe Deadbolts Vault Other Other*Are any of the collectibles stored in a basement or other areas below ground? Yes No Are any of the collectibles kept in a public storage facility? Yes No Are any of the collectibles stored outdoors? Yes No Policy Start Date* MM slash DD slash YYYY You are insuring $0 worth of . The quote has been sent to Yearly price $0/year To buy this policy, please confirm the statements below: Have you ever had a felony or bankruptcy? Choice Yes No Have you had a home owners or collectibles claim or been denied/canceled or non-renewed insurance coverage in the last 5 years? Choice Yes No Do you want to include an Automatic increase in the value of your collection? Learn more This is an optional coverage that may be added to your policy for new acquisitions and appreciation of existing collectibles. Selecting this coverage will apply an automatic monthly increase of 1% in coverage, up to a maximum of $1,000,000. This coverage can be added or removed at anytime via request. Choice Yes No In the event of loss I am able to provide proof of ownership. This includes photos with an inventory list, or transactional records, or an appraisal. Choice Yes No This field is hidden when viewing the formHave you filed for bankruptcy in the last 5 years? Yes No This field is hidden when viewing the formHave you ever been convicted of a felony? Yes No This field is hidden when viewing the formHave you filed a claim in the last 5 years? Yes No EmailQuote Number Checking Policy You are insuring $0 worth of . The quote has been sent to Yearly price $0/year To buy this policy, please confirm the statements below: Have you ever had a felony or bankruptcy? Yes No Have you had a home owners or collectibles claim or been denied/canceled or non-renewed insurance coverage in the last 5 years? Yes No Do you want to include an Automatic increase in the value of your collection? Learn more This is an optional coverage that may be added to your policy for new acquisitions and appreciation of existing collectibles. Selecting this coverage will apply an automatic monthly increase of 1% in coverage, up to a maximum of $1,000,000. This coverage can be added or removed at anytime via request. Yes No In the event of a loss I am able to provide photos, or an inventory list, or other documentation of my collection. Yes No This field is hidden when viewing the formUntitled Yes No This field is hidden when viewing the formUntitled Yes No This field is hidden when viewing the formUntitled Yes No Δ
