The Burtnett Agency LLC
600 East Penn Street Bedford, PA 15522
(814) 623-8419
Whatever your insurance needs may be,
call The Burtnett Agency
.

Submit you information and we will contact you with a quote

Submit you information and we will contact you with a quote
Your name:
Spouse's name:
Address:
Email Address:
Phone Number:
Current Insurance Company:
Coverage Information
Other Structures:
Mobile Home Coverage:
Personal Property:
Additional Living Exp.:
Personal Liability:
Medical Expenses.:
Deductible:
Underwriting Information
Year of mobile home:
Tied Down?:
Road Miles from Fire
Department:
Dogs? If yes how
many and what breed:
Trampoline?:
Fire Extinguishers?:
Any Woodburners?:
Roofing Type:
Primary Heat Type:
Any Claims in the past 5 years? If yes please explain:
Home Update Years
Roof:
Heat:
Plumbing:
Electric: