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  1. Type of Insurance

  2. Building Square Feet

  3. Building Value

  4. Distance to Nearest Firehall

  5. Discounts (check if applicable)

  6. How long do You Rent Your Cottage per year

  7. Options (check if applicable)

  8. Liability Coverage

  9. Deductible

  10. Contact Information

  11. How Did You Hear About Us

  12. Follow Up

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