Valuable Items Insurance Form What type of asset would you like to insure? High-Value Home Is the cost of rebuilding the building more than $1M (excluding the amount of the land) Yes No ------------------- Jewelry How much jewelry would you like to insure? (optional) How much do you estimate the value of this jewelry to be? (optional) Do you have appraisals or invoices for this jewelry? Yes No ------------------- Art Work How many works would you like to insure (artworks, paintings, sculptures or other)? (optional) How much do you estimate the value of these works of art to be? (optional) ------------------- Wines Approximately how many bottles of wine would you like to insure? (optional) Do you have a wine cellar? Yes No ------------------- Cars How many cars would you like to insure? (optional) What type of vehicle is it? E.g Lamborghini, Ferrari, vintage or antique vehicle) (optional) ------------------- Collections and others What objects are in your collection (e.g., silverware, crystal glass, coins, stamps, etc.)? (optional) How much do you estimate the value of this collection to be? (optional) ----------------------- Your info First Name Last Name Email Phone Number When would you like to be contacted? ASAP Book a time What day would you like us to contact you? Monday Tuesday Wednesday Thursday Friday Time preference (optional) Morning (8:30 AM – 12:00 PM) Afternoon (12:00 PM – 5:00 PM) How would you like to be contacted? Phone Call Email Additional Information / Comments: (optional) Want to get service directly? Skip the form and call 1 844 312-8524
