Phone 831-462-3222 • Fax 831-462-3251
6990 Soquel Dr., Aptos, CA 95003 •
sean(at)rovaiinsurance.com (replace (at) with @ when emailing)
Home
* Indicates Required Field
*Name:
*Phone Number:
Fax Number:
*Email:
*Preferred Means Of Contact:
Email
Phone
Fax
*Address:
*City:
*State/Province:
*Zip/Postal Code:
*Occupation:
*Year Built:
*Square Footage:
*Number Of Stories:
*Roof Type:
*Exterior Type:
*Number Of Bathrooms:
*Is There A Laundry Room?:
Yes
No
If so, on which floor?
*Is There A Garage?:
Yes
No
If so, is it attached or detached?:
Attached
Detached
How many cars does it hold?
*Is this your primary home, a seasonal home, a landlord property or do you rent this property?
*
*If this is a landlord property, how many units are there?
*
Additional Comments:
We have included this code to avoid spam.
If you cannot read the letters or numbers, click on the audio icon.
Please note that the code is case sensitive.
Enter Code*:
