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About Our Homeowners Program
PA online home insurance information and quotes
What Sets OUR Homeowners Products Apart from the rest?

low rates on PA home owners insurance plans  ° Save over 20% with home & auto discount!

 ° We write older homes!

 ° Homes 50 yrs and newer eligible for up to 40% off!

 ° Water and Sewage backup coverage available.

 ° Low rates and Same-Day policy issue!

Get your FREE Pennsylvania Homeowners Quote NOW!

 
 
On-Line Automobile
Insurance Quote Form
One Simple Form - takes only 2-3 Minutes!


Your Personal Data

Your Name:
Street Address:
City:
State: (Must be Pennsylvania)
Zip Code:
E-Mail (REQUIRED):
E-Mail again for accuracy:
Phone:
Fax (optional):
 
Marital Status:
Single Married
Homeowner?
Yes No
 
Currently Insured?
(If yes, list carrier, and # of years
continuous. If none, type N/C)


DRIVER INFORMATION #1
Name: Birthdate:
Sex (M/F): # Years U.S.
 Licensing:
Be specific to tell if accidents are "at-fault" or "NOT-at-fault" - (carriers require proof on NOT-at-fault accidents); Also, be specific as to TYPE of violations, and approximate DATES of each in the fields below:
Number & Type of Accidents last 3 years: Number & Type of MINOR violations last 3 years:
Number & Type of MAJOR violations last 3 years: Daily commute
in ONE WAY miles:
Does Driver need
an SR22 FILING?
Yes No If YES to SR22 filing, why needed?
(list accident/cite)


DRIVER INFORMATION #2 (if none, leave blank)
Name: Birthdate:
Sex: # Years U.S.
 Licensing:
Be specific to tell if accidents are "at-fault" or "NOT-at-fault" - (carriers require proof on NOT-at-fault accidents); Also, be specific as to TYPE of violations in fields below:
Number & Type of Accidents last 3 years: Number & Type of MINOR violations last 3 years:
Number & Type of MAJOR violations last 3 years: Daily commute
in ONE WAY miles:
Does Driver need
an SR22 FILING?
Yes No Comments or
Remarks?
If More than 2 Drivers, list Additional Driver's Names, Birthdates, and driving record history here:


VEHICLE #1 INFORMATION
(if "Non-Owners", type "NON-OWNER" in "YEAR" Field)
Year of vehicle: Make & Model:
Vehicle ID# (for rating accuracy):
Annual Mileage: Used in business?
(Explain, if yes):
VEHICLE #1 COVERAGES:
Select Liability Limits
 
Select Comprehensive Deductible:
 
Select Collision Deductible:
 
Uninsured Motorists
Coverage?
YES NO
 
Rental Car &
Towing Coverage?
YES NO
 
Medical and/or
PIP Coverage?
YES NO
 
 
VEHICLE #2 INFORMATION (if none, leave blank)
Year of vehicle: Make & Model:
Vehicle ID# (for rating accuracy):
Annual Mileage: Used in business?
(Explain, if yes):
VEHICLE #2 COVERAGES:
Select Liability Limits - - - Liability Limits Must
Match Vehicle #1 - - -
 
Select Comprehensive Deductible:
 
Select Collision Deductible:
 
Uninsured Motorists
Coverage?
YES NO
 
Rental Car &
Towing Coverage?
YES NO
 
Medical and/or
PIP Coverage?
YES NO
 
Comments or Remarks:
(List additional drivers, autos, etc. here)
If More than 2 Vehicles or Drivers, list Additional Vehicles Year, Makes, and Models, and Driver's Ages and Driving records here:


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Questions? E-Mail Us At: quotes@pa-homeinsurance.com | Our Pennsylvania Insurance License #: 365642
Buhl Insurance Agency Inc. . 4204 East Ewalt Road . Gibsonia, PA 15044 . Phone: 724-443-5610 . Fax: 724-443-5622

PA-Home Insurance.com has made purchasing Pennsylvania homeowners insurance EASY. We have developed a website where anyone can find, compare, and purchase Pennsylvania home insurance online. We provide you access to the nations leading insurance carrier to find you the best value on PA home insurance and other homeowners insurance products. Letting us shop for you allows you to save money on your Pennsylvania homeowners insurance through a top Pennsylvania insurance carrier. Get a free quote on your Pennsylvania home insurance today. Keywords used by customers to find us online include: Pennsylvania homeowners insurance, PA homeowners insurance, low cost Pennsylvania home insurance, PA homeowners insurance policies for Pennsylvania, pennsylvania home insurance quotes.

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