- Blue Bridge Insurance Agency Custom Home Quote Form

This website is SSL protected. Please note that your information will never be sold or used for anything outside of determining your insurance rate.

The most efficient way to get an apples to apples comparison and recommendation is to text or e-mail your current insurance declarations page with all of the coverages to 616-916-2009 or Ryan@Bluebridgemi.com.

Also if there is not a line item listed on your current declarations page for valuable personal property please include those details as well.

Home Owners Quote - Personal Information

We quickly respond to all quote requests.
Please provide as much detail as possible so all applicable discounts can be applied.
Only the first 6 boxes are required to have a quote.
Another option is to text a picture of your current coverages to 616-916-2009 or E-mail to Ryan@bluebridgemi.com

Blue Bridge Insurance Agency LLC
300 Washington Ave Suite 100
Grand Haven, MI 49417

* Indicates required field

Name: *

First

Last

Address that will be insured: *

Phone Number: *

Email: *

Date of Birth: *

marital status: *

Additional Named Insureds and DOB's: *

Mailing Address (If different than location address): *

Do you Currently have Insurance? *

Yes No No - New Purchase

Name of Current Insurance Company? *

Approximate Length of Time with Current Company? *

Expiration Date of Current Policy? *

Dwelling Information

Current replacement cost on the dwelling? *

Home status: *

Date applicant became owner of residence? *

Interior fire suppression system? *

Alarm system details as applicable? *

Smoke Detectors? *

Deadbolt Lock? *

Pool *

Dogs? (Please list number and breed) *

Livestock on premises? *

Household Claims or Property Losses in the last 5 years if applicable? Has your insurance been canceled, declined, or non-renewed in the last 5 years? (Please Explain) *

Submit

Dwelling Information

Contact