Select Church Insurance Services

Location with contents

For customers, please complete the appropriate form below. Please note that submitting a change request does not bind coverage. Incomplete information may cause a delay in processing your request. Upon receipt of your request, we will contact you.

By clicking "Submit", you agree to provide Select Church Insurance Services with the submitted information about you and / or your organization, that you are authorized agent and / or representative of the organization, that you have the authority to submit this request, and that the information provided is accurate.

Ministry Name** Ministry Name is required.Ministry City** Ministry City is required.

Policy Number (Last 6 Numbers)

Date to start coverage** Date to start coverage is required.

New Location AddressStreet Address** Street Address is required.City** City is required.State** State is required.Zip** Zip is required.County** County is required.Inside City Limits

Primary Use

What is the Value of the contents at this Location?

Does Ministry Rent or Own BuildingTenant Improvements Coverage Required? (For Rentals Only)

If Yes, What Amount

Approximate Square Footage used by your ministry

Building InformationType of Construction

How many stories is this building

Roof Information

Approximate Roof Age

Approximate Age of Building

Approximate Age of Heating

Approximate Age of Plumbing

Approximate Age of Electrical

Does this location have a boiler that requires state inspection?Miles to Fire DepartmentDistance from Fire HydrantSprinkler System?Alarm Protection?If Yes, What type?Is there a Motion Detector?Are Alarms monitored by a Centralized Station? Building has a Boiler Building has a Generator Building has a Wood Burning Stove

Open/Drag files to UPLOAD Here

Location with contents

Specials