Homeowners Insurance Quote Form
We would like to provide you with a free, no-obligation Homeowners Insurance quote.  Please provide as much information as possible for the most accurate quote.  This information will be kept confidential and will be used for quote purposes only.

Personal Information
Today's Date
Name
Address
City State
Zip Code
Day Phone   Night Phone
Best Time to Call   AM PM
Email Address
How Long at Current Job?
Occupation


Current Homeowners Insurance Information
Company Name (not agency)
Policy Expiration Date   Premium Amount
Amount Insured For   Policy Type Primary Secondary
Term 6 Months 1 Year


Home Information
How Long at Present Address   Year Home Was Built
Sq. Footage (excl. garage and basement)   # of Claims in Last 3 Years


Structure Information
Type1 Story 1.5 Story 2 Story Ranch Split-Level
ConstructionFrame Brick Modular
RoofAsphalt Shingle Shake Shingle Tile         Age of Roof (years)
FoundationConcrete Poured Slab
Garage1 car 2 car 3 car 4 car         Attached Y N


Features
Number of Bathrooms Basement Deck/Porch/Patio Garage


Sq. Feet
Deck Sq. Ft.
Porch Sq. Ft.
Screened Patio Sq. Ft.
# of Fireplaces

# of Chimneys  


Additional Features
Type of Heating System Central Air Central Vac Security Alarm Smoke Detector Fire Alarm
Y N Y N Y N Y N Y N


Additional Comments
Please give any additional comments your feel appropriate for this quotation. If you have additional infomation where there was not enough space, please enter them here.


About Brenneis Insurance


Brenneis Insurance Agency, Inc. has been incorporated and in business in Tekamah, Nebraska since 1979.  Brenneis Insurance is a member of the The Independent Insurance Agents of Nebraska and has numerous relationships with Independent carriers and national brokers.

Kevin Brenneis, CIC is owner and principal of Brenneis Insurance Agency, Inc. Kevin has been in the insurance industry since 1996 and received his Certified Insurance Counselor designation in 2003.



  




 

Get a Quote


Brenneis Insurance Agency, Inc. is a full service agency offering many types of insurance coverage.  To be of better service to you, we have equipped this site with links for you to submit information to receive auto, home, life, disability, and health insurance quotes.    <<read more>>

If you would like to receive commercial insurance or farm quotes, you will need to contact Kevin Brenneis at the agency or send him an email with your contact information so he can gather the appropriate information.


Get a Quote here!
Click here to access our Quote Forms.



Kevin Brenneis, CIC

Kevin Brenneis, CIC is owner and Principal of Brenneis Insurance Agency, Inc. Brenneis Insurance has been in business in Tekamah, Nebraska since 1979.

Contact Us Now

Brenneis Insurance Agency

129 S. 13th Street
Tekamah, NE  68061

Phone:  402.374.1911
Mobile:  402.870.0693
Fax:        402.374.1915

Email Us

World Class Customer Service

Our office is fully staffed with trained professionals who are also licensed agents and customer service reps.  Lucille Eriksen, Kristi Gross, Sheryl Stansberry and Cathy Zink are available to help you with all of your personal insurance needs. 



 We all look forward to serving you!

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