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Lavinder Group & Associates Insurance Agency Mission Statment
Lavinder Group & Associates Insurance Agency Vision
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"It is without reservation that we would recommend Lavinder Group and Associates for you insurance needs."

-Betty Bailey, Danville Urologic Clinic

Check Us Out Lavinder Group on LinkedIn

To receive an Home Insurance quote please fill in the information below. Please type N/A for non-applicable fields.

Insured's name:  Insured's DOB:(mm/dd/yyyy) 
Spouse's name:  Spouse's DOB:(mm/dd/yyyy) 
Mailing Address:  City   State   Zip Code 
Phone Number:  Email Address: 
 
Location of Dwelling (If different from Mailing Address): 
City:   State:   Zip Code: 
 
Replacement Cost of Dwelling: (Current Coverage Amount on Home) 
Medical Payments:   Liability Payments:    Deductible: 
Year Built:   Square Footage:   Date Purchased: 
Heat Source:   Roof Type:   In City Limits? Yes No 
 
Smoke Detector? Yes No      Fire Extinguisher? Yes No      Deadbolts? Yes No     
Swimming Pool? Yes No      Trampoline? Yes No     Pets? (List Breed)
Any losses in past 5 years? Yes No      Explain (if Yes): 
Is home more than 15 years old? Yes No 
Buglar Alarm/Sprinkler System(type) 
 
Additional Coverage Items (Guns, Fine Arts, Furs, Jewelry, ect)
NameCoverage Amount
Item 1
Item 2
Item 3
Item 4
 
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