This form is to be used by Realtors® to order coverage online.
If you are a home buyer/seller, please use our Buyer/Seller Form.
This process takes less than 2 minutes.
If you prefer, you may order by phone instead.
Payment will be arranged later.

Ordering Agent:
Office Name:
Office Address:
City:
Zip:
Phone:
Fax:
Email:
Are you the:	Buyer's Agent
	Seller's Agent
	Transaction Coordinator
Party Responsible for Payment?
Buyer Name:
Seller Name:
Daytime Phone:
Evening Phone:
Fax:
Address of property to be covered:
City/ZIP:
Title Company:
Main Phone:
Fax:
Closer/Contact:
City/ZIP:
Date Closing:
Please Click here to review the Terms of Coverage. I have read, understood, and agree to the Terms of Coverage.
Standard Coverages:
Seller's/Buyer's Coverage (12 mo. buyer) $275 Seller's/Buyer's Coverage (15 mo. buyer) $295 Buyer's 2 Year Option $525 Condo/Townhome Seller's/12 mo. Buyer's Coverage $255 Condo/Townhome Seller's/15 mo. Buyer's Coverage $275 Condo/Townhome 2 Year Buyer's Option   $475 All plans are for single family dwellings under 5000 sq. ft. For dwellings over 5000 sq. ft., guest cottages and /or multiple systems/appliances, call for quotes.
Optional Coverages (Only available for buyer - per year):
Air Conditioner/Cooling $75 Clothes Washer & Dryer $50 Septic Tank Pumping $45 Well Pump $75 Limited Roof Leak Repair $60 Pool and/or Spa Equipment $150 Gas Fireplaces $60 Furnace Exclusion Deduction $55 Call for quote on multiple units (available Buyer only)
New Construction:
Basic 2 Year $250 Basic 4 Year $495 Coverage begins on the 1st anniversary of the closing date and continues for 2 or 4 years provided the fee has been received at CHW with 10 days of close of sale. SERVICE FEE $55 PER TRADE CALL
I hereby declare that to the best of my knowledge and belief, all systems of the property to be covered by this warranty are currently in good working order or are listed below. I understand that excluded items will be reinstated when Colorado Home Warranty, Inc. receives proof of repair.
Exclusions:
Additional Comments:
Please review your entries, then click below: