Verma Insurance

Our goal is to provide you with the best insurance coverage at the lowest price, coupled with superior customer service and carrier reliability.


Auto Quote

Home Quote

Request Home Quote:

Contact Info

First Name: Last Name:
Address: Apt#:
City: State: Zip:
Phone: Email:

Other Info:

Your Date of Birth: Number of Adults:
Referred By:

About Your Home:

Number of Units: Living Sq. Foot:
Year Built: Number of Stories:
     Carpet: % Tile: %
     Hardwood: % Vinyl: %
     Marble: % Stone: %
     Other: %
Number of Car Garages: Number of Bathrooms:
Number of Fireplaces: Kitchen Countertop:
Swimming Pool/Spa: Deck:
Roof Type: Roof Age:
Exterior Type:
Other Feature/Upgrade:

Info For Discounts:

Burglar Alarm:

Prior Insurance Information:

Prior/Current Carrier:
Home Purchase Date:
No. Of Claims in last 3 yrs:
Please provide Claim date and details, if any:

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