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:
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  Zip:
  Home Phone: area code
  Work Phone: area code     Ext.
  Fax Phone: area code    
  Email:   

Home Characteristics 
  Number of Stories:
  Square Feet:
  Year Built:
  Foundation:
  Garage:
  Full Bathrooms:
  Half Bathrooms:
  Fireplaces:
  Roof Type:
  Central A/C?:
  Central Alarm?:
  Central Smoke Alarm?:

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

Coverages
  Deductible:
  Liability:   
  Medical:
  Earthquake?:

Additional Comments