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Gross Insurance Agency

More About Gross
Insurance Agency

Gross Insurance Agency,
has two offices located
in Ft. Thomas,KY and
Walton, KY, and has been
assisting Kentucky
residents and businesses
for over three decades.

We represent many of our
state's leading insurance
companies and provide the
service you deserve.

Remember, "every policy we sell comes with an agent!"
Call: 859-781-0434

Map & Directions to Our Main Ft. Thomas, KY Office
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Homeowners Insurance
Quotation Form
One Simple Form - takes only 2-3 Minutes!

Your Personal Data:
Your Name:
Property Address:
Your "County" is?
State: (Must be Kentucky)
E-Mail again for accuracy:
Fax (optional):
Primary Insured's Occupation:
Primary Policyholder's Birthdate:
(REQUIRED - Some companies products
offer discounts for certain age groups.)
Dwelling Information
Year Home Built:
Home Square footage:
Is this Builder's Risk?
(new home constr.)
Month/Year home
to be complete:
Number of units: 1 family Duplex
Type foundation: Basement
Crawlspace over slab
Other (list in remarks)
(If basement, what % is finished?)
Type Construction: Frame
Other (list in remarks)
Type Roof: Shingle
Wood Shake
Spanish Tile
Metal Other
Number of stories: One 1.5
Two Three
Do you own animals or pets? Yes No
If yes, list type/for dogs, list breed:
Are You Near Brush Area? Yes No
# of feet to nearest
fire hydrant:
# of miles to nearest
fire station:
Does Home Have a Garage? Yes No
Tell whether built in, detached/attached, and how many cars?
Currently Insured? Yes No
Name of Carrier & how long insured?
Prior Claims? Yes No
Describe claims in detail:
Rate Your Credit History and Past Insurance Payment History:
(Some companies products are
based on your credit and payment history.)
Excellent Fair
Poor Horrible
Plumbing type: Copper Galvanized
Mixed (Copper/Galvanized)
Heating Type: Gas (Propane or natural)
Oil (if oil, list tank location in remarks)
Circuit Breakers or fuses? Breakers Fuses

# Bedrooms: # Bathrooms:
# Fireplaces: # Chimneys:
Special features
(i.e., deck, air conditioning, alarm systems, pool, etc.)
Dwelling Cov. $ Contents $
Liability Cov. $ Deductible $
($250, $500, $1,000, etc.)
(describe any scheduled jewelry, in-home business, oil tank location, or other special coverages/remarks here):
Send my quotation via: E-Mail Fax
Regular Mail
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FT. THOMAS OFFICE: Gross Insurance Agency, LLC | 26 N Ft. Thomas Avenue - PO Box 75249 | Ft. Thomas, KY 41075-0249
Phone: 1-859-781-0434 | Fax: 1-859-781-1780 | E-Mail us at:

WALTON OFFICE: Gross Insurance Agency, LLC | 24 N Main Street - PO Box 205 | Walton, KY 41094-7107
Phone: 1-859-485-7102 | Fax: 1-859-485-7107 | E-Mail us at:

About Us | Privacy Notice | Service Request | KY Insurance License #600690

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