Home Warranty Order - California
Home
*Coverage:
Select OPTIONS
  Seller's Coverage - Home (add $0.69 per day)
  Seller's Coverage - Condo (add $0.61 per day)
  $60 Air Conditioning / Evaporative Cooler
  $125 Pool/Spa Equipment
  $50 Additional Pool/Spa
  $50 Kitchen Refrigerator w/Ice Maker & Dispenser
  $50 Washer/Dryer
  $100 Roof Coverage (limited)
  $100 Extended Pipe Leak
  $120 Well Pump System Coverage
  $50 Septic System/Sewage Ejector Pump
  $20 Septic Tank Pumping
  $50 MAXIMUM UPGRADE Option
  $20 Red Tag Option sm
  $100 Relocation/Alteration ($1,000 Limit)
  $200 Structural Endorsement  (REQUIRES CHECKLIST COMPLETED AND SIGNED BY AN APPROVED INSPECTOR)
  10/30 OPTION  (Add 10% to the Total Coverage and reduce $55 Trade Call Fee to $30).
TOTAL 
For Price Quote For DUPLICATE SYSTEMS(On Homes Over 5000 sq.ft. Or Multiple Units.) Please call (800)443-5599.
*Contract Holder Name
*Property Address
*City  *State      *Zip 
*Phone
Submitted by Agent
Submitted by Coordinator
*Real Estate Firm     
*Agents Name        *Phone Number
*Address              
Coop Agent Company
Cooperating Agent  Phone Number
Address                   
If you provide us with your E-Mail Address and a 4 to 6 character Password you can use Click-To-Cover on-line ordering and receive instant confirmation of your orders.
Email Address    Password
Submitted by Closing Agent
*Closing Company
*Closing Officer   *Phone   
*File Number   *Expected Close Date 
*Address
City   State    Zip
If you provide us with your E-Mail Address and a 4 to 6 character Password you can use Click-To-Cover on-line ordering and receive instant confirmation of your orders.
Email Address    Password
Comments:
PROPERTY   DISCLOSURE   REPORT   (Issued by Buyers Real Estate Service)
Assessors Parcel Number
County
Seller Name

Return Via:

Priority Mail    Fax     Email
Deliver To:
Seller's Agent         Escrow



PLEASE FILL IN REQUIRED FIELDS ( * ) TO COMPLETE ORDER.