Keener Insurance: Quality insurance for a qreat value. Auto, Home, Life, Business


Home & Tenant Insurance

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Keener Insurance Agency, Inc
13880 Braddock Rd Suite 305
Centreville, VA 20121
703-631-9834 : Office
703-830-6785 : Fax

The more information you fill out on this form, the faster and more accurate your quote.
OR Use our quick contact form and we will contact you by phone or email.

 
First Name:
Last Name:
Date of Birth:
Home Phone:
Work Phone:
Cell Phone:
Email Address:
Current Address:
City:
State:
Zip Code:
Number of years at your current address:
Is this address the one you intend to insure?
Yes No
Name of current insurance company?
Address of Insured Location:
City:
State:
Zip Code:

Select which best fits your insurance needs?

If you own the dwelling,
what is the value of the Dwelling?
$

How much personal property do you own?
$

Amount of Personal Liability coverage desired?

Desired Deductible?

Is residence within 1,000 ft of a Fire Hydrant?
Yes No

How far away is the responding fire station?

Which of these are present in the insured dwelling:

Deadbolt Locks   Wood Stove
Smoke Detectors Fire Extinguishers
Central Alarm      Detached buildings / structures Swimming Pool (above ground)
Swimming Pool (below ground)

Please enter any Home Owner / Tenant claims you've made in the last 5 years.

Please give date, description and amount.

If you have any additional comments, please list them here:

Notice of Licensure Keener Insurance Agency, Inc. is licensed to conduct business in the states of Virginia and Maryland. The information on this site is a solicitation to conduct business only in the aforementioned state(s) of authority.

Keener Insurance...


     ...values each individual as
our priority.

We will keep your personal information confidential and answer your correspondence promptly.

Keener Insurance has been providing peace of mind for 30+ years.

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