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Jeff Mangelli
Location:
7451 Auburn Blvd # B
Citrus Heights, CA
95610
Phone: (916) 728-4050
Fax: (916) 728-4070
CA Lic#: 0C22228
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Name
Address 1
Address 2
City
State
Zip Code
Email
Daytime Phone
Evening Phone
Do you have Home Insurance?
Yes
No
Present Insurance Company
Expiration Date of Current Policy
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other
Are you 55 and retired
Yes
No
Number of Claims in the Past 5 Years
0
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5
more
Occupation
How Long At Present Job
1
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0
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Mo
Square Footage of Home (Excluding Garage and Basement?)
Style
Stories
Year Built
Contemporary
Victorian
Townhouse
1 Story
1.5 Story
2 Story
2.5 Story
3 Story
Split Level
Select
1900-1949
1950
1951
1952
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No. of Units
Construction
Foundation
1
2
3
4
Frame
Brick/Masonry
Concrete
Concrete Slab
Crawl Space
Basement (Unfinished)
Basement (Finished)
Garage
Kitchens
Bathrooms
None
Attached
Built-In (Rooms Above)
Detached
1 Car
2 Car
3 Car
4 Car
standard
custom
deluxe
1
1.5
2
2.5
3
3.5
4
4.5
Fireplace
Heating System
yes
no
Oil
Electric
Gas
Exterior
(must equal 100%)
select
Clapboard
Wd siding
Wd shingle
Alum siding
Vinyl siding
Stucco
Brick Veneer
Stone Veneer
Solid Brick
Solid Stone
Conc Block
Stucco & Block
Log
Adobe
100%
90%
80%
70%
60%
50%
40%
30%
20%
10%
select
Clapboard
Wd siding
Wd shingle
Alum siding
Vinyl siding
Stucco
Brick Veneer
Stone Veneer
Solid Brick
Solid Stone
Conc Block
Stucco & Block
Log
Adobe
100%
90%
80%
70%
60%
50%
40%
30%
20%
10%
select
Clapboard
Wd siding
Wd shingle
Alum siding
Vinyl siding
Stucco
Brick Veneer
Stone Veneer
Solid Brick
Solid Stone
Conc Block
Stucco & Block
Log
Adobe
100%
90%
80%
70%
60%
50%
40%
30%
20%
10%
select
Clapboard
Wd siding
Wd shingle
Alum siding
Vinyl siding
Stucco
Brick Veneer
Stone Veneer
Solid Brick
Solid Stone
Conc Block
Stucco & Block
Log
Adobe
100%
90%
80%
70%
60%
50%
40%
30%
20%
10%
Roof
(must equal 100%)
select
Asphalt Shingle
fiberglass shingle
comp shingle
wood shingle
wood
heavy wood shake
slate
conc tile
Mexican tile
Other
100%
90%
80%
70%
60%
50%
40%
30%
20%
10%
select
Asphalt Shingle
fiberglass shingle
comp shingle
wood shingle
wood
heavy wood shake
slate
conc tile
Mexican tile
Other
100%
90%
80%
70%
60%
50%
40%
30%
20%
10%
Interior Partitions
(must equal 100%)
select
Sheetrock
Plaster
Block
Brick
Adobe
Studs Only no finish
100%
90%
80%
70%
60%
50%
40%
30%
20%
10%
select
Sheetrock
Plaster
Block
Brick
Adobe
Studs Only no finish
100%
90%
80%
70%
60%
50%
40%
30%
20%
10%
Interior Wall Coverings
(must equal 100%)
select
Paint
Average Paper
Ornate Paper
Grass Paper
Plywood Paneling
Heavywood Paneling
Millwork
Knotty Pine
Ceramic Tile
Deluxe Tile
Brick
Cork
Stone
Mirrors
Book Case Wall
Stucco
Marble Tile
100%
90%
80%
70%
60%
50%
40%
30%
20%
10%
select
Paint
Average Paper
Ornate Paper
Grass Paper
Plywood Paneling
Heavywood Paneling
Millwork
Knotty Pine
Ceramic Tile
Deluxe Tile
Brick
Cork
Stone
Mirrors
Book Case Wall
Stucco
Marble Tile
100%
90%
80%
70%
60%
50%
40%
30%
20%
10%
select
Paint
Average Paper
Ornate Paper
Grass Paper
Plywood Paneling
Heavywood Paneling
Millwork
Knotty Pine
Ceramic Tile
Deluxe Tile
Brick
Cork
Stone
Mirrors
Book Case Wall
Stucco
Marble Tile
100%
90%
80%
70%
60%
50%
40%
30%
20%
10%
select
Paint
Average Paper
Ornate Paper
Grass Paper
Plywood Paneling
Heavywood Paneling
Millwork
Knotty Pine
Ceramic Tile
Deluxe Tile
Brick
Cork
Stone
Mirrors
Book Case Wall
Stucco
Marble Tile
100%
90%
80%
70%
60%
50%
40%
30%
20%
10%
Ceiling
(must equal 100%)
select
Sheetrock
Plaster
Acoustical Tile
Tin
Wood
Mirror
Millwork/Crwn Mold
100%
90%
80%
70%
60%
50%
40%
30%
20%
10%
select
Sheetrock
Plaster
Acoustical Tile
Tin
Wood
Mirror
Millwork/Crwn Mold
100%
90%
80%
70%
60%
50%
40%
30%
20%
10%
Flooring
(must equal 100%)
select
Hardwood
Wall2Wall Carp avg
Wall2Wall Carp lux
Avg Carp ovr HdWd
Lux Carp ovr HdWd
Vinyl
Parquet
Plank
Slate
Tile($2)
Deluxe Tile($14)
Terrazzo
Flagstone
Marble
Brick
Stone
100%
90%
80%
70%
60%
50%
40%
30%
20%
10%
select
Hardwood
Wall2Wall Carp avg
Wall2Wall Carp lux
Avg Carp ovr HdWd
Lux Carp ovr HdWd
Vinyl
Parquet
Plank
Slate
Tile($2)
Deluxe Tile($14)
Terrazzo
Flagstone
Marble
Brick
Stone
100%
90%
80%
70%
60%
50%
40%
30%
20%
10%
Additional Features
Smoke Detectors
Fire Extinguishers
Local Security System
Central Station Security System
Dead Bolts
Local Fire Alarm
Central Station Fire Alarm
Central Air Conditioning
Central Vacuum
Wet Bar
Whirlpool Tub
Deductible
Personal Liability
$100.00
$250.00
$500.00
$1,000.00
$100,000
$250,000
$250,000
$300,000
$500,000