German Mutual
914 Alden DR
Auburn, NE 68305
402.274.3106
800.458.0064
402.274.3135 fax

HOME QUOTE

Please note: This is not an offer for insurance.
This quote is for comparison shopping.
WE ONLY WRITE INSURANCE COVERAGES IN THE STATE OF NEBRASKA

Contact Information

Name

Address - Line 1

Address - Line 2

City

State

Zip

Home Phone

Email Address

How would you like to be contacted?

Mail

Email

Phone

Responding Fire Department

Property Section

Year of Construction

Type of Construction

Frame

Brick

Modular

Mobile Home

If mobile home please list model & manufacturer

Current Dwelling Coverage

Replacement Cost

Yes

No

Contents Amount

Contents Replacement Cost

Yes

No

Please use the following box to list any items you may have insured specifically. (ie: jewelry, computer)

Liability Section

Number of Acres

Liability Coverage

100,000

300,000

500,000

1,000,000

     Increased Property Damage is $500

Medical Payments

1000

2000

3000

4000

5000

Any livestock on premise?

Yes

No

Please list any liability endorsements on your current policy.

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