Click Here to download a printable version of the Shipley Home Warranty Application.

Note: You must have Adobe Acrobat Reader installed to view this application.

Step One: Choose the plan that's right for your home

Prices below are for single family dwellings under 5,000 square feet.  Call to obtain a quote on alternate dwelling types. 
   
Buyer Coverage
  $375  $395
Buyer/Seller Coverage
  $439  $459
Premium Coverage - Buyer/Seller
  $479  $499
 
A trade service call of $79.95 will be charged per repair visit, or the actual charge, whichever is less.  Additional charges may apply to certain repairs and replacements. See coverage terms.
 

Step Two: Select your optional coverage
Ice Maker
$15
Stand-Alone Freezer
$35
Swimming Pool Equipment
$150
Spa Equipment*
$145
Washer / Dryer
$75
Well Pump
$85
   
* Spa option required if pool and spa run on separate systems
 

Step Three: Tell us about yourself
Property address to be covered:
Address: 
City: 
  State:    Zip: 
Heat Source: 
Natural Gas  Propane  Oil Heat  Electric / Heat Pump
 
Please check appropriate box for initiating agent
Seller Information
Seller Name:
Phone Number:
( )
Email:
Mailing address:
City: 
  State:    Zip: 
Real Estate Company:
Agent Name:
Email:
Phone Number:
( )
Listing Exp. Date:
(mm/dd/yyyy)
 
Buyer Information
Buyer Name:
Phone Number:
( )
Email:
Mailing address:
City: 
  State:    Zip: 
Real Estate Company:
Agent Name:
Email:
Phone Number:
( )
   
Closing Company Information
Closing Company Name:
Phone Number:
( )
Fax Number:
( )
Estimated Closing Date:
(mm/dd/yyyy)  Closing No. 
Closing Rep Name:
Email:
 
The total warranty plan fee (including basic coverage and any optional coverage items selected) is due and payable to SHW.  Buyer coverage is paid at closing.  Buyer/Seller coverage must be paid with the submission of the application.  The warranty plan fee includes a service fee payable to the above named real estate company for administrative and other services performed in the placement of the plan, including promoting, selling, processing and advertising the plan.
When a covered item breaks down due to normal wear and tear, contact Shipley Home Warranty Plan.  Shipley Home Warranty Plan will contact an authorized service contractor who will call you to schedule a convenient time to diagnose the problem.  Please do not call a contractor yourself.  Shipley Home Warranty Plan will not reimburse for work performed without its prior approval.
 

Step Four: Please check the appropriate box(es) and sign
I desire:  
The Shipley Home Warranty Plan (checked above)
 $ 
Optional Coverage Total (checked above)
 $ 
   
Contract Total*
$ 
*Sales tax will be added where required by law  
   
To decline the benefits of this coverage.  I agree not to hold the above real estate company, broker and/or agents liable for the repair or replacement of a system or appliance that would otherwise have been covered by this warranty plan.
   
By entering my name below, I agree with the terms and conditions stated in the Shipley Home Warranty Plan contract, and I verify that all information entered on this form is true and complete to the best of my knowledge.
   
Full Name:  Date: 
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