Carrier Insurance Agency
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Have a question? Give us a call today!

(814) 226-6580

Toll-free: (800) 822-9486

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   Fill out the information below, and one of our representatives will contact you shortly with an accurate home insurance quote.

   For more information on our policies, feel free to call one of our friendly representatives at (814) 226-6580 or toll-free at (800) 822-9486.


Policy Holder Information
First Name:*   Last Name:*  
Address:*
City:*   State:*  
Zip Code:*  
Email:*  
Work Phone:   Home Phone:*  
Is the property address the same as the policy holder's address?*
Yes No
 
Property Address
Address:*
City:*   State:*  
Zip Code:*  
 
Occupancy Information
Occupancy:*  
County:  
Township:  
Distance from Fire Hydrant:  
Distance from Fire Station:  
 
Fields marked * are mandatory
Construction Information
Construction:*  
Mobile Home:  
Length: Width:
Tie Downs:  
Year Constructed:  
Square Footage:*  
Number of Floors:  
Basement:  
Smoke detector: Yes   No  
Central fire alarm: Yes   No  
Central burglar alarm: Yes   No  
Heating:
Oil Gas Propane Electric
Vent Less Heater Hot Water Baseboard In-floor Radiant Heating Fireplace
Fireplace Insert Wood Burner Wood/Coal Furnace Other
Other:  
Other Structures:
Attached Garage Unattached Garage Shed Barn
Workshop Car Port Breeze way Other
Other:  
 
Other Amenities
Number of pets:  
Trampoline: Yes No  
Above ground pool: Yes No  
Inground pool: Yes No  
Water Craft:  
Marine Engine:  
Horsepower:  
Length:  
Equipment:  
Other:  
 
Fields marked * are mandatory
Business on Premises
Is there a business on the premise?*
Yes No
Type of business:  
Number years in business:  
Is the business solely ran from the house: Yes   No  
How much square footage is used by the business:  
Value of business property on premise:  
Number of employees:  
Do you have business insurance: Yes No  
 
Current Insurance Information
Current Dwelling Amount:  
Current Content Amount:  
Current Other Structure Amount:  
Current Liability Amount:  
Current Deductible Amount:  
Expiration Date:  
Current Company:  
Special Personal Property & Value:
Jewelry Firearms
Furs Coin Collections
 
Prior Claims
 
How Did You Hear About Us?
 
 
Fields marked * are mandatory
**Please note that this quote is not final until an agent contacts you**


Location

Carrier Insurance Agency
21823 Rt. 68 Suite 3
Clarion, PA 16214
Phone: (814) 226-6580
Toll-Free: (800) 822-9486
Fax: (814) 226-8514

Email: carrierinsagencyinc@hotmail.com
Directions
(in front of Tractor Supply)

Office Hours

Monday - Friday: 8:00 AM - 5:00 PM

Companies We Represent
Erie Insurance
Progressive Insurance
Millvale Insurance