KING & BRIM INSURANCE, INC.
Your Independent Agents For A Lifetime
 

Family-owned and operated and serving metro Atlanta since 1953!
  Home ● Auto ● Life  
  Business ● Health  
  770-522-9411  


Use our SECURE site to get a quote on coverage for your home, health, auto & life.  We will NEVER sell or misuse your information.

  Condo/Renters Insurance (For Fee Simple Townhome/Condo, please fill out Homeowners application.)  
 
 How did you find us?
 Applicant:
 Applicant D.O.B. (Required)
 Retired?

Owner or Renter:   

 Co-Applicant:
 Street:
 City:
 State:    Zip:
 Phone:

Alternate Phone:   

 Best time to contact: Preferred method of contact:
 E-mail Address:
 How long have you been at this address?   
 Current Insurance Company? (Not Agency)  
 Expiration Date  

Previous address (IF at current address for less than 1 year):
 Street:
 City:
 State:    Zip:
       
 
  Condo Address (if different from above information).  
 
 Street:
 City:
 State:    Zip:
 Number of Units:
 
 
Protection Devices		  
   Smoke Detectors

Fire Extinguishers

 
   Dead Bolts

Central Burglar / Fire Alarm

 
 
Coverage		  
   Personal Contents Amount    
   Deductible Amount    
 
High Value Items		  
   Jewelry $

Silver

 $

Cameras

 $

Furs

 $  
   Fine Arts $ Other:  
     
 

Comments:

 
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