Full Name:          
Address to be Insured:
South Carolina
Zip Code:
Email Address: (Required) 
Home Phone:   Work Phone:   Ext.
How to Contact You:
Date of Birth:              (mm/dd/yyyy)

Do you currently have SC Coastal Homeowners Insurance?
Coverage requested for?
Usage Type:
Years Lived at Address to be Insured:  

SC Coastal Homeowners Insurance Coverages & Limits of Liability:

Dwelling ($ value):
Additional Structures ($ value):
Personal Property ($ value):    

Personal Liability (each occurence):
Medical Payments (each person):   

Policy Endorsements:

Replacement Cost, Dwelling: Yes No
Replacement Cost, Contents: Yes No

South Carolina Coastal Homeowners Insurance - Dwelling Information:

Building Structure:
Year Dwelling Built:     Dwelling Square Feet:
Primary Heat Type:
Do you have a Wood Stove? If yes, is it on a separate flue?

Full Baths:     Half Baths:   
Garage:         Garage Size:

Type of Wiring:         
Wiring Renovation:         Wiring Renovation Year:   
Plumbing Renovation:     Plumbing Renovation Year:
Heating Renovation:       Heating Renovation Year:  
Roofing Renovation:       Roofing Renovation Year:  
Roof Type:     Roof Age (years):
Exterior Paint Renovation:     Exterior Paint Renovation Year:

Dwelling Distance from Fire Department:  miles
Dwelling Occupied By:
Swimming Pool:              Diving Board:
Approved Fence:  

Loss History:

Did you have any losses, whether or not paid by insurance, during
the last 3 years, at this dwelling location or any other location?
If the answer to the previous question was "Yes", please explain below.

Date                            Type                          Description of Loss           Loss Amount

Additional Information or Comments

Click on the "Submit Quote Request" button below to send your
South Carolina Coastal Homeowners Insurance quote request.**

**Information received from this SC Coastal Homeowners Insurance quote request
form sent to Russell-Massey & Company will be for our use only and will not
be sold given to or distributed to any other parties. A quote will be based on the
South Carolina coast homeowners insurance policy information provided and does
not guarantee acceptance of the risk by us. The precise coverage afforded is subject
to meeting underwriting guidelines, and the terms, conditions and exclusions of
the policy as issued. By submitting this request you acknowledge that this is
neither an offer to insure nor a guarantee of insurance. Completion of this
form does not entitle you to a South Carolina Coastal Homeowners Insurance
policy. We are licensed in South Carolina will not provide quotes for other states.

South Carolina
Coastal Homeowners
Insurance Quote
We offer lower cost South Carolina Coastal Homeowners Insurance
coverage in Columbia, SC and throughout the Palmetto State!
Russell-Massey & Co.
of Columbia, SC offers
affordable and
experienced personal
insurance coverage
services throughout
South Carolina.
Contact us about South
Carolina Auto, Renters,
Homeowners, Boat,
Motorcycle, Disability,
and Health Insurance toll
free at (800) 849-7475.
In addition to South
Carolina Coast
Homeowners Insurance
quotes, we also offer
affordable RV Insurance
policy quotes.
We are a Columbia, SC insurance agency offering affordable
South Carolina coast homeowners insurance policy quotes in the
following towns, cities and counties in South Carolina: Chapin,
Arthurtown, Saluda Terrace, Sandwood, Arcadia Lakes, Cayce,
Olympia, Forest Acres, Dentsville, Eau Claire, West Columbia,
Springdale, Denny Terrace, Belmont, St. Andrews, Irmo, Oak
Grove, Lexington, Galaxy, Bluff Estates, Hazelwood Acres, State
Park, Haskell Heights, Lincolnshire, Ballentine, Killian, Red Bank,
South Congaree, Edmund, Gilbert, Summit, Gaston, Hopkins,
Capitol View, Horrel Hill, Fort Jackson, Pontiac, Elgin,
Blythewood, Camden, Richtex, Whitehall, White Rock, Sumter,
Lugoff, Boykin, Rembert, Hagood, Horatio, Stateburg, Borden,
Wedgefield, Oswego, Gadsden, Fort Motte, St. Matthews,
Swansea, Woodford, Winnsboro, Pelion, Steedman, Samaria,
Monetta, Batesburg-Leesville, Stoney Hill, Prosperity, Newberry,
Peak, Little Mountain, Slighs, Pomaria, Jenkinsville, Rion,
Winnsboro Mills, Simpson, Smallwood, Ridgeway, Orangeburg,
Lexington County, Fairfield County, Calhoun County, Sumter
County, Kershaw County, Saluda County, and Richland County,
SC. We can also offer a cheaper South Carolina coast
homeowners insurance coverage quote throughout the Palmetto
state, including in Florence, Greenville, Spartanburg, Myrtle
Beach, and Charleston, SC.
Applicant Information
Your South Carolina
Coast Homeowner
Insurance Quote Source
Russell-Massey & Co.
1320 Elmwood Avenue
Columbia, SC 29201
Richland County, SC
Toll Free: (800) 849-7475
Office: (803) 779-7854
Fax: (803) 799-6546
Russell-Massey & Co.
409 Lexington Avenue
Chapin, SC 29036
Lexington County, SC
Office: (803) 941-3650
Fax: (803) 941-3654
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