Insurance Division

Competitive Rates

Independent Agents for:
  • Auto
  • Home
  • Farm
  • Business
  • Life
  • Health
  • Allstate Insurance

  • Badger Mutual

  • General Causality

  • Germantown Mutual

  • Safeco Insurance

Homeowners Insurance Quote Form

Applicant Information:

Name Telephone
Address e-mail
City State Zip
Dwelling Year of Construction
.
Coverage Amounts:
Dwelling:    . Contents: 
Other Structures:     10%  Loss of use  20%
Personal Liability:  Medical: 
Deductibles:  Woodburner: 
Any business conducted on premises?
If yes to business, what:
Inside city limits: -  If no, miles from fire dept:
.

    Additional Comments:

Please be sure all information on this form is correct before submitting for quote.

   
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Information provided by your on this form will be kept confidential. 

Dodgeville Office:

158 N. Iowa St
Dodgeville, WI. 53533
Phone: 608-935-2396
Toll Free: 877-253-7878
Fax: 608-935-9714

Mineral Point Office:

241 High St.
Mineral Point, WI. 53565
Phone: 608-987-2142
Toll Free 877-235-4573
Fax: 608-987-3936 

info@pottertonrule.com