Bean Insurance Agency
1310 Broadway
Mt Vernon, Illinois 62864
(618) 242-6017
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Ownership
Rent
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Own a Home
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Own Condominium
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Home Details
Families
How many families live in your unit?
Single Family
Two Families
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Number of Stories
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1 Story
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Building Type
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Families
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Number of Stories
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Year
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Square Footage
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Construction
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Brick
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Fire Resistant
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Semi Wind-Resistive
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Roof Type
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Aluminum
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Roll Roofing
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Roof Shape
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Help me choose
Select Shape
Gable
Hip
Gambrel
Mansard
Complex / Custom
Flat
Shed
Hail Resistant Roof
Do you have a hail resistant roof?
No
Yes
I don't know
Baths
How many full baths (tub, toilet, shower, sink)?
½ Baths
How many half baths (toilet, sink)?
¾ Baths
How many three quarter baths (toilet, shower, sink)?
Heating
How is your house heated?
None
Baseboard Heater
Ceiling Heater
Central Electric
Central Gas
Open Flame Source
Permanent Space Heater
Portable Space Heater
Wood Burning Stove
Other
Pool
Do you have a pool?
No
Yes
Pool Type
What kind of pool do you have?
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Above Ground
In Ground
Trampoline
Do you have a trampoline at this location?
No
Yes
Animals
Do you have any of the following furry friends?
None
Dog - Akita
Dog - Alaskan Malamute
Dog - American Bull Terrier
Dog - American Staffordshire Terrier
Dog - Bull Mastiff
Dog - Chow
Dog - Dingo
Dog - Doberman
Dog - German Shepherd
Dog - Husky
Dog - Pit Bull
Dog - Pit Bull Terrier
Dog - Presa Canario
Dog - Mix
Dog - Rottweiler
Dog - Staffordshire Bull Terrier
Dog - Wolf Hybrid
Dog - Other Breed
Livestock - Cow
Livestock - Horse
Livestock - Other
Pet Insurance
Would you like insurance for your pet?
No
Yes
Earthquake Insurance
Would you like earthquake insurance?
No
Yes
Windstorm Insurance
Would you like windstorm insurance?
No
Yes
Condition
Needs Work
One Star Rating
My place is in need of a few repairs and upgrades.
Good
Two Star Rating
My house has been maintained and is in good condition.
Most properties fall into this category.
Excellent
Three Star Rating
This property is attractive with upgrades and within a desired neighborhood.
Discounts
Car Discount
Currently Insured
No
Yes
Currently Insured
Is this property currently insured?
No
Yes
Prior Carrier
Which carrier are you currently insured with?
Select One
AFFIRMATIVE INSURANCE COMPANY
ALLIED AUTO
ALLSTATE PROP AND CAS INS CO
AMERICAN FAMILY MUTUAL
BRISTOL WEST INS CO
COUNTRY MUTUAL INS CO
DAIRYLAND COUNTY MUTUAL INS CO
DIRECT GENERAL INS CO
ENCOMPASS PROPERTY AND CAS CO
ERIE INSURANCE EXCHANGE
FARM BUREAU MUTUAL INS CO
FOREMOST INS CO GRAND RAPIDS MI
FOUNDERS INS CO
GEICO CASUALTY CO
GUIDANT MUTUAL INS CO
HARTFORD CASUALTY INS CO
KEMPER AUTO AND HOME INS CO
MERCURY CASUALTY COMPANY
OTHER
PEKIN
SAFECO INS CO OF IL
STATE FARM MUTUAL AUTOMOBILE INS CO
TRAVELERS INDEMNITY CO OF AMERICA
Current Monthly Payment
How much do you pay for property insurance each month?
Gated Community
Do you live in a gated community? If so, what type?
Not gated
Single Entry Gated
24-Hour Security Patrol
24-Hour Manned Gates
Pass-Key Gates
Burglar Alarm
Is your property actively monitored with a burglar alarm?
None
Monitored
Unmonitored
Fire Alarm
Is your property actively monitored with a fire alarm?
None
Monitored
Unmonitored
Contents
Computers
Do you have computers, laptops and tablets?
No
Yes
Electronics
Do you have stereos, TVs, game consoles and other electronics?
No
Yes
Jewelry
Do you have a lot of jewelry?
No
Yes
Applicant
Date of Birth
Gender
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Non-Binary
Marital
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Married
Single
Divorced
Widowed
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Education
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Bachelors Degree
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No High School Diploma
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Industry
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Homemaker(full-time)
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Agriculture/Forestry/Fishing
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Construction/Energy/Mining
Education/Library
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Food Service/Hotel Services
Government/Military
Information Technology
Insurance
Legal/Law Enforcement/Security
Medical/Social Services/Religion
Personal Care/Service
Production/Manufacturing
Repair/Maintenance/Grounds
Sports/Recreation
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Occupation
What is their role?
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Owner Operator
Do you own or operate this business?
No
Yes
Business Insurance
Would you like insurance for your business?
No
Yes
Co-Applicant
Is there a co-applicant?
No
Yes
Co-Applicant
Name
What is this person's name?
Lang.LastName
Relation
Relation to
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Insured
Spouse
Child
Other Related
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Parent
Date of Birth
Gender
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Marital
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Complex / Custom
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Shed
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