Permission to Contact/Optional Coverage Survey
Our agency standard is to receive permission from you before using your mobile number for service and marketing purposes, sending you a text message, and before using an automated dialer to leave you a message (We often use an automated dialer and a text message to notify you of an upcoming policy renewal and to leave you birthday and holiday greetings.) Providing your mobile number as a contact number constitutes express consent that our agency can use that number to contact you by the methods you select below
Contact Info
First Name *
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Last Name *
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What is the best contact number to reach you to discuss insurance related items?
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Is the primary number you provided above a mobile number
If you provided a cell number, may we text message you if it is important that we contact you and/or send you a birthday greeting?
Optional Coverage Section
Please read the description of the optional coverage and accept or decline adding the coverage to your policy. These are optional coverage and are not part of your base policy. Any 'accept' answer will trigger a call from the agency concerning the coverage. Only mark accept if you want to add or discuss the coverage.
Towing/Roadside Assistance
Pays the cost of labor done at the initial place of accident or breakdown along with towing, up to the policy limits.
Rental Reimbursement
Reimbursement for the cost of a replacement vehicle while your vehicle is being repaired as a result of a covered loss.
Full Glass
Most of us have had our windshield chipped by a rock coming off another vehicle while driving. Some of our carriers offer glass coverage with a low or zero deductible for a minimal increase in premium. This is a great option because if the chip spreads and the windshield need replacement it is generally an out of pocket expense because a windshield usually costs less than your deductible.
Identity Restoration Coverage
Provides reimbursement for covered expenses such as attorney's fees, lost wages, loan application fees, & other expenses. Coverage varies by company. (Est cost $30/year)
Scheduled Personal Property
(SPP) is a convenient way to extend coverage for your valuable items such as: jewelry, furs, watches, silverware, fine artwork, computers, golf equipment and collectibles. These items have limitations on a base policy. This coverage is highly recommended for individual items valued over $1,000. (Average $9 per thousand scheduled)
Water Back Up and Sump Discharge/Overflow
A base homeowners policy does NOT cover damage to your home or personal property in the event of sewer or drain backup which overflows from a sump pump or similar system.
Higher Medical Payments Limit
With all the uncertainty in today's health insurance market and an increase in people without health insurance it has become more common to hold higher medical payment limits on auto & home insurance policies.
Flood Coverage
Property insurance does NOT cover flood damage. You must obtain a policy through the Federal Emergency Management Agency (FEMA) if additional coverage is needed. We can sell and administer this policy for you!
Although earthquakes are not common in our area they do happen and can cause damage. "Earth Movement" is excluded from a homeowners policy by default. Click 'accept' below if you would like a quote for your home.
Personal Umbrella
A Personal Umbrella Policy provides additional financial protection beyond the base limits on you auto and home policy. There are minimum limits that must be met to prevent a gap in coverage.
Life Insurance *
We strongly recommend that you meet with our in house life insurance expert or your agent. We offer many options to fit any need or budget.
Please click on any additional policy type you would like our agency to quote for you.
Send us a referral and if they qualify to receive a quote you will earn a your choice of a $25.00 gift certificate or a free car wash. (One certificate per policy quoted) While we appreciate each referral you send to us, we can only reward you for the referrals that meet our qualifying guidelines. Each policy type has its own unique qualifying quidelines. Send us the referral and we will let you know immediately if you are eligible for the reward. Put the referrals name and the best contact phone number and/or email for them in the box below.
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All of us at Gnade Insurance Group work hard to provide the best overall experience available in the insurance industry. Please take a moment to write a short review or comment about our agency that we can post on our website and share with others that are trying to find out more information about our agency. Long or short, your comments are very valuable to us. Thank you in advance for you time and your kind words. Put your comment in the box below.
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Which of our staff serviced you today? *
By clicking the submit button I acknowledge and understand that it constitutes express written consent that Gnade Insurance Group can contact me at the phone numbers I have provided on this form, for the purposes stated above, by a combination of phone calls or text message as selected by me.
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