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Application for Guardian Residential Warranty
Coverage Options
6 months coverage
$260 		14 months coverage
$345 		18 months coverage
$485

Home Buyer Coverage Options:
Home Seller Coverage Options:
Additional Water Heater $40 Additional Water Heater $40
Additional  Central Air & Heat $95 Additional Furnace $60
Hot tub or Whirlpool bath tub $85 Additional A/C & Furnace $95
Swimming Pool $125 Additional Coverage Options
Swimming Pool & Tub Combo $150 Multi-Family 1st Addt'l $200
Central Vacuum System $25 Each Addt'l Unit $250
Drain Stoppage $45 Condominium Discount -$20
Roof Leak Repair $40 Non-Owner Occupied $150
Water Well Pump $75
Septic Tank Pump $35
Washer/Dryer $35


ALL PROGRAMS COME WITH $75 DEDUCTIBLE
For $50 Deductible please add the additional amounts
Single family residence $30
Condominium $25
Multiple Family $50
TOTAL POLICY AMOUNT:

APPLICANT:         BUYER      SELLER
Last Name:
First Name:
Street:
City:     State:    Zip:  
Phone:
Square Footage:
Property Owner Occupied
Hazard Insurance Company:
ISSUING AGENT:
Agent Company:
Agent Phone:
Title Company:
Title Phone:
Closing Date:
Funding Date:
GRW Sales Rep:
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Copyright Guardian Residential Warranty Inc. 2007