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Buyer Name and Phone Number
*
Buyer Email
*
Seller Name and Phone Number
Seller Email
Full Address of Warranted Property
Street Address
City
ZIP Code
Real Estate Agent's Name
*
Real Estate Agent's Phone Number
*
Real Estate Agent's Email
*
Title Company/Escrow Officer's Name
Title Company/Escrow Officer's Phone Number
Title Company/Escrow Officer's Email
Warranty Package Options (Please Select ONE)
*
Basic • 1 Year Coverage $400
Platinum • 1 Year Coverage $500
Alpine • 1 Year Coverage $625
New Construction • 2 to 5 Year Coverage $650
Optional Coverage Options (Select All That Apply)
Washer and Dryer (1 set) • $100
Central Vacuum System • $25
Refrigerator (1 unit) • $50
Double Oven • $50
Roof Coverage • $100
Pre-Paid Deductible • $50
Re-Key (No deductible due) • $100
Payment Options
Please select one
Paying credit/debit card
Paying by check
Paying through closing
Salesperson
Please select one
Jeremy
Loren
None
Instructions, Information, & Property Condition
Property Condition Declaration
*
Please select one
All items are in good working order
Some items are NOT in good working order
Special instructions, information, or please note any defective items
• Alpine Home Warranty does not reimburse. You must call prior to service. There is a $60 service call deductible. • By submitting, I hereby declare that to the best of my knowledge and belief, all systems of the property to be covered by AHW are currently in good working order or are listed above. I understand that excluded items will be reinstated when AHW receives proof of repair or replacement. *Please call our office outside of regular business hours to be connected with our 24 hour emergency service.
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Home
Services/Apply
Order A Warranty
Inspections
Radon Mitigation Systems
Submit A Claim
Contact & FAQ
Contact Us
Contract Details
AHW Blog