Realtor Information Realtor First Name* Realtor Last Name* Realtor Type * —Buyer's agentListing agentBoth Realtor Phone* Realtor Email* Company Name* Company Address* Company City* Company State* Company State*KSMO Company Zip Property Information MLS Number Property Address* Property City* Property State* Property State*KSMO Property Zip* Property Listing Date* Seller Information Name* Primary Phone Alternate Phone Email Address Buyer Information Name* Primary Phone Alternate Phone Email Address Closing Company Information Company Name* Closing Officer Name Closing Date Email Address Closing Phone Basic Coverage The Carefree Home Warranty BASIC COVERAGE includes two heating and cooling systems, plumbing (including one water heater), electrical, and built-in appliances (dishwashers, ranges, range hoods, built-in microwave, cooktops, ovens, warming drawers, and trash compactors only). Carefree Home Warranties require that ALL heating and cooling systems and all water heaters on the premises be covered. Boilers also require additional coverage. Please use the section below to indicate boilers, additional heating and cooling systems, or additional water heaters. Description Price Base Home Warranty Plan $484.00 Base Home Warranty Plan Total Optional Additional Coverage Per Year Qty Description Price Total Per additional heating & cooling systems (after 2) $99/yr Additional water heater $82/yr Boiler (includes gas valves, ignitors, pilot safety, thermocouples, transformers, pilot) $220/yr Merv 10 filter (twice per year) $99/yr Merv 16 filter (twice per year) $123/yr Ultra-violet bulb change $148/yr Zone controls $186/yr Steam canister humidifiers $201/yr Back-up sump pump (excludes batteries) $88/yr Water softener $99/yr Power vent water heater $99 Ground source heat pump (per system) $600 Septic tank $120/yr Sewer ejector $132/yr Electronic air cleaner $52/yr Clothes washer/dryer $89/yr Freestanding freezer $79/yr Additional refrigerator $79/yr Duplex $822/yr Triplex $1,234/yr Fourplex $1,645/yr Two year plan $790/yr Optional Coverage Total Grand Total Please leave this field empty.