Add or Delete a Property/Location

Client Information

Broker Name(Required)

Name(Required)

First Last

Company Name(Required)

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone

Email(Required)

Property/Location Information

Add or Delete Property/Location(Required)

Add property/location

Delete property/location

Effective Date(Required)

Property/Location Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

If adding property/location, the following fields are required:

Number of Stories

Year Built

Square Footage

Basement

Yes

Year of Last Updates (if over 30 years old)

Roof

Heating/AC

Plumbing

Electrical

Building Construction (frame, brick, steel, etc.)

Building Occupied As

Other Occupants

Check All That Apply

Sprinkler system

Fire alarm

Burglar alarm

Personal Property (contains) Limit in $

Cost to Replace Building in $

Improvements and Betterments Limit in $

Computers Replacement Cost in $

Mortgage Holder

Comments

When you've finished entering your information, please press the Submit Form button. Thank you for choosing the Charles L. Crane Agency.

Important Notice Any information submitted via this website does not constitute a binding agreement to your policy or coverages. Insurance coverage cannot be bound, altered, or canceled without confirmation from a licensed insurance representative. If you have questions, please feel free to contact us.