Real Estate Investor Quote Request Complete the below request form and our team will be in touch ASAP. "*" indicates required fields 1Contact Info2Property 1 Info3Property 2 Info4Property 3 Info5Property 4 Info6Wrap-up Info How many separate properties do you need a quote for right now?*If you need quotes for more than 15 properties, please email REI@riskwell.com and we will personally assist with your request.1234Are 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 Your Name* First Last Your Date Of Birth* Month Day Year Is the property 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 - Property 1* 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 - Property 1 Building Type - Property 1**Please note we are not able to provide coverage for mobile manufactured homes*Single Family Residence2-4 UnitsCondoTownhouse# Of Units - Property 1*Tell us the number of units that you own/need coverage for. Intended Use - Property 1*Long-Term RentalFlip/RehabShort-Term Rental (AirBNB/VRBO)VacantBuilding Coverage Amount Needed ($) - Property 1*For a "flip" property, use the purchase price + your renovation estimate to determine the property coverage amount.Monthly Rent - Property 1*Purchase Method - Property 1*Conventional PurchaseCreative Financing MethodCreative Financing Method - Property 1*Sub 2Seller FinanceWholetailPolicy Payment Method - Property 1*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 - Property 1?*Yes, there is a lender/mortgageeNo, there is not a lender/mortgageeLender/Mortgagee Name - Property 1*Please provide the full name of the lender. Lender/Mortgagee Email - Property 1*Input the primary contact email for the lender/mortgagee Lender/Mortgagee Mailing Address - Property 1* 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 mailing address for underlying seller - Property 1* Physical Address - Property 2* 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 - Property 2 Building Type - Property 2*Single Family Residence2-4 UnitsTownhouseCondo# of units - Property 2*Intended Use - Property 2*Long-Term RentalFlip/RehabShort-Term Rental (AirBNB/VRBO)VacantBuilding Coverage Amount Needed ($) - Property 2*For a "flip" property, use the purchase price + your renovation estimate to determine the property coverage amount.Monthly Rent - Property 2*Purchase Method - Property 2*Conventional PurchaseCreative Financing MethodCreative Financing Method - Property 2*Sub 2Seller FinanceWholetailPolicy Payment Method - Property 2*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 - Property 2?*Yes, there is a lender/mortgageeNo, there is not a lender/mortgageeSame Lender/Mortgagee For Property 2 As With Property 1?Yes, same lenderNo, different lenderLender/Mortgagee Name - Property 2Please provide the full name of the lender. Lender/Mortgagee Email - Property 2Input the primary contact email for the lender/mortgagee Lender/Mortgagee Mailing Address - Property 2 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 mailing address for underlying seller - Property 2* Physical Address - Property 3* 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 - Property 3 Building Type - Property 3*Single Family Residence2-4 UnitsCondoTownhouse# of units - Property 3*Intended Use - Property 3*Long-Term RentalFlip/RehabShort-Term Rental (AirBNB/VRBO)VacantBuilding Coverage Amount Needed ($) - Property 3*For a "flip" property, use the purchase price + your renovation estimate to determine the property coverage amount.Monthly Rent - Property 3*Purchase Method - Property 3*Conventional PurchaseCreative Financing MethodCreative Financing Method - Property 3*Sub 2Seller FinanceWholetailPolicy Payment Method - Property 3*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 - Property 3?*Yes, there is a lender/mortgageeNo, there is not a lender/mortgageeSame Lender/Mortgagee For Property 3 As With Property 1?Yes, same lenderNo, different lenderLender/Mortgagee Name - Property 3Please provide the full name of the lender. Lender/Mortgagee Email - Property 3Input the primary contact email for the lender/mortgagee Lender/Mortgagee Mailing Address - Property 3 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 mailing address for underlying seller - Property 3* Physical Address - Property 4* 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 - Property 4 Building Type - Property 4*Single Family Residence2-4 UnitsCondoTownhouse# of units - Property 4*Intended Use - Property 4*Long-Term RentalFlip/RehabShort-Term Rental (AirBNB/VRBO)VacantBuilding Coverage Amount Needed ($) - Property 4*For a "flip" property, use the purchase price + your renovation estimate to determine the property coverage amount.Monthly Rent - Property 4*Purchase Method - Property 4*Conventional PurchaseCreative Financing MethodCreative Financing Method - Property 4*Sub 2Seller FinanceWholetailPolicy Payment Method - Property 4*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 - Property 4?*Yes, there is a lender/mortgageeNo, there is not a lender/mortgageeSame Lender/Mortgagee For Property 4 As With Property 1?Yes, same lenderNo, different lenderLender/Mortgagee Name - Property 4Please provide the full name of the lender. Lender/Mortgagee Email - Property 4Input the primary contact email for the lender/mortgagee Lender/Mortgagee Mailing Address - Property 4 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 mailing address for underlying seller - Property 4* 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?* If this is a Rehab/Flip, are you acting as your own General Contractor for your deals?*Your property insurance program DOES NOT cover construction liability. You need General Liability Insurance even if you're only acting as a GC on your own deals.No, I am not acting as my own GC for my deals.Yes, I'm my own GC. Please help me get General Liability Insurance for that exposure.Yes, I'm my own GC. I already have General Liability Insurance for that and don't need your help.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, email and ringless voicemail as needed. This consent has no time restriction and is offered in perpetuity. 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..