Ground Up Construction Quote Request Complete the below request form and our team will be in touch ASAP. "*" indicates required fields 1Contact Info2Property Info3Wrap up Are you a current client of RiskWell?*No, I'm a new clientYes, I'm a current clientWhat effective date do you want for your new insurance?*Please note, we are not able to backdate coverage. Today's date is the first available day for coverage to begin. Month Day Year How long is the project expected to take?* Your Name* First Last Your Date Of Birth* Month Day Year Is the project held in your personal name or another legal entity (LLC, etc...)*Held in my personal nameHeld in another entity (LLC or other)Entity Name* Phone Number*Email* Mailing Address* Street Address Address Line 2 City State AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Physical Address* Street Address Address Line 2 City State AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code County Building Type*Single Family Residence2-4 UnitsMultifamily (5+ units)Commercial Property# Of Units*Tell us the number of units that you own/need coverage for. Are you the GC or the Developer*General ContractorDeveloperBothOtherHow many years of experience do you or your GC have as a General Contractor?* Building Coverage Amount Needed ($)*For a "flip" property, use the purchase price + your renovation estimate to determine the property coverage amount. Square footage of dwelling:* Construction type?*FrameJoisted MasonryNon CombustibleHow many stories will the building be?*12345Policy Payment Method*Note that if you select "title company or escrow account" you will be required to enter lender/mortgagee information.I'm paying for this policy directlyI'm paying through a title company or escrow accountLender/Mortgagee*Yes, there is a lender/mortgageeNo, there is not a lender/mortgageeLender/Mortgagee Name*Please provide the full name of the lender. Lender/Mortgagee Email*Input the primary contact email for the lender/mortgagee Lender/Mortgagee Mailing Address* Street Address Address Line 2 City State AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Full name and contact info of GC that will be assisting on this project* Do you need a companion FLOOD INSURANCE quote for this property?*Yes, please help me get a flood quoteNo, I am declining the offer of a flood quoteHow did you first hear about RiskWell? Personal Referral Google Search McKinney Chamber of Commerce Local event Facebook Group/Post YouTube video Word of mouth Who referred you to us?* What else do we need to know to deliver you an outstanding experience?Communication Consent*RiskWell is committed to respecting our current and future clients' privacy and communication preferences. So that we may remain compliant with state and federal regulations, we need your expressed permission to communicate with you using phone, text and email as needed. You may opt-out of all future communication at any time by making your preferences known to us. RiskWell operates by the simple rule of "treat other people the way you want to be treated." I authorize RiskWell to communicate with me using the information provided on this form for the purpose of assisting with my insurance program..