John B. Andrews, Inc.
30376 Esperanza, Suite 300
Rancho Santa Margarita, Ca. 92688
Office: (949) 589-1114
E-mail: john@rsminsurance.com
   
 


 
















Contact Information
  Your Full Name:
  Property Address:
  City:
  State:
  Zip:
  Home Phone:
  Work Phone:     Ext.
  Fax Phone:    
  Email:   

Home Characteristics:
  Square feet: 
  Year Built: 
  Full Bathrooms:
  Half Bathrooms:
  Roof Type:
  Central A/C?
  Central Alarm?
  Central Smoke?
  Date Purchased:

Miscellaneous:
  Age 55 + Retired?
  Scheduled Personal Property Items:
  Belong to Homeowners Association? 
  Claim in last 3 Years?
  If Yes give details:

Contents Coverage
  Deductible:
  Liability:
  Medical:
  Earthquake?

Additional Comments