Tiny Homes

As seen on ProgramBusiness.com, our Tiny Home Insurance Program is offered in all 48 of the Continental United States.

If you have questions about the form, please contact Martin@cig-llc.biz. You can also schedule a call with him here: https://calendly.com/martinburlingame/15min/

In the meantime, you can also read more about our program here: Tiny Home Insurance Q&A with Martin Burlingame.

If you do not complete the Agency information, the quote will be sent to Martin@martinburlingame.com.

Applicant Name

Occupation

Date of Birth

Marital Status

Co-Applicant Name

Co-Applicant Occupation

Co-Applicant Date of Birth

Co-Applicant Marital Status

Do you have an existing tiny home insurance policy?

Name of Carrier

Any Prior Claims?

Total in Claims

Tiny Builder

Trailer Builder

Additional Optional Information

Value of Home

$45000.00

Typically valued between $25,000 and $150,000. If more, please call us.

Purchase Price

$50000.00

Purchase Date

Serial Number

Other Structures

We can offer additional coverage for detached buildings, built on porches, and items such as solar panels.

Contents

Include all loose items in your tiny home. (pots, pans, clothing, bed, T.V., stereo, etc...

Theft of Contents

The policy normally does not cover theft of your personal belongings. We can add theft coverage up to $3,000 for a small charge.

Trip Endorsement

We can cover you when you move your tiny home.

Estimated Moves Per Year

If Trip Endorsement is selected.

Theft of Tiny Home

Interested in Financing?

Personal Liability

Liability covers slips/falls and getting sued.

Medical Payments

Each person

Please select your dwelling location:

Year Built

2017

Number of Rooms

Square Feet

400 sq. ft.

Length in Feet (Not Tongue)

26 ft.

Width in Feet

8 ft.

Height in Feet

13.5 ft.

Construction

Type of Roofing

Primary Heat Source

Wood Stove or Fireplace

Please select your usage type:

Does the applicant own, keep or shelter any animal with a previous bite history or any non-domestic animals?

Does the premises have a swimming pool or spa?

Has the applicant had a homeowners/dwelling policy cancelled or non-renewed for any reason?

Has the applicant filed for bankruptcy in the past 36 months?

Has the applicant been 30 days past due on mortgage payments in the last 12 months?

Is there any unrepaired or existing non-structural damage in the dwelling?

Is there a business operating from the tiny home?

Are there multiple horses, livestock or farm animals on the premises?

Is there a dock, pier or boat house on the premises?

Is the dwelling on 5 or more acres?

Are farming activities conducted on the premises?

Has the home been uninsured for more than 30 days immediately prior to the requested effective date?

Does not apply to a new purchase.

Does the dwelling have permanently installed steps and handrails, if 3 or more steps, on all entrances?

Is the dwelling located within 1,500 feet of a body of water?

Is the dwelling tied down when parked at its primary location?

Is there a mortgage?

*****Note you MUST hit submit for our underwriters to receive it. If you haven’t received an email confirmation, please be sure you hit SUBMIT. Call Ashley at 719-476-0107***