Vacation Rental Quote Request
Producers Name
First Name
Last Name
Producers Email
example@example.com
Producers Phone Number
-
Area Code
Phone Number
Named Insured
First Name
Last Name
Vacation Rental Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
-
Area Code
Phone Number
Mailing Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Contact Information
First Name
Last Name
Email
example@example.com
Phone Number
-
Area Code
Phone Number
What Type of Coverage do You Need?
Property and Liability
Liability Only
Do You Rent Individual Bedrooms?
Yes
No
Is One of the Properties You Provided Your Primary Residence?
Yes
No
Have You Owned this Short Term Vacation Rental for More than 3 Years?
Yes
No
Have You Incurred Any Insurance Claims Against Any of Your Vacation Rental Properties?
Yes
No
Date of Loss
-
Month
-
Day
Year
Date
Description of Loss
Is Claim Open or Closed?
Total Claim Amount Incurred
Total Cost to Rebuild all the Structures on your Property?
Total Cost to Replace all the Contents Inside your Buildings?
What is the Annual Gross Income You Generate on this Property?
Please Select a Desired Property Deductible
$2,500
$1,000
$5,000
$10,000
$25,000
What is the Main Construction Type of the Buildings on your Property?
I don't know
Frame with wood siding/brick veneer/stone veneer
Joisted Masonry
Non-Combustible
Modified Fire Resistive
Fire Resistive
What is the Oldest Year of Construction of the Buildings on Your Property?
How Many Bedrooms in Total do You Have in all Buildings?
Do You Have a Pool on the Premise that You Control?
Yes
No
Do you allow renters to use the water amenities?
Yes
No
Is your pool or hot tub in compliance with the Virginia Graeme Baker pool and spa safety act?
Yes
No
Other
Is the fencing around your swimming area in compliance with all Federal, State and Local laws, codes and ordinances?
Yes
No
Other
Is your fencing securely locked when your pool or hot tub area is not in service?
Yes
No
Other
Do you have safety rules posted near your pool, spa or hot tub?
Yes
No
Other
Do you have "No Swimming Allowed" signs posted during times when pool or hot tub use is not permitted?
Yes
No
Other
Are water depth markings clearly visible along the sides of the pool?
Yes
No
Other
Are all pool drain systems and drain covers in compliance with all Federal, State and Local laws, codes and ordinances?
Yes
No
Other
If you have underwater pool lighting with more than 15 volts, does it have GFCI protection?
Yes
No
Other
Are all chemicals stored in a secured location?
Yes
No
Other
Do you have "Swim At Your Own Risk" signs posted?
Yes
No
Other
Is safety (i.e. lifesaving) equipment present, in good working order and available for immediate use, as required by all Federal, State and Local laws, codes and ordinances?
Yes
No
Other
Do you have any diving boards?
Yes
No
Other
Do you have a slide?
Yes
No
Other
Do you have a spa or hot tub?
Yes
No
Other
Do you allow renters to use these water amenities?
Yes
No
Other
Is your pool or hot tub in compliance with the Virginia Graeme Baker Pool and Spa Safety Act?
Yes
No
Other
Do you have safety rules posted near your pool, spa or hot tub?
Yes
No
Other
Do you have "No Swimming Allowed" signs posted during times whenpool or hot tub use is not permitted?
Yes
No
Other
Are all chemicals stored in a secured location?
Yes
No
Other
Do you have "Swim At Your Own Risk" signs posted?
Yes
No
Other
Is safety (i.e. lifesaving) equipment present, in good working order and available for immediate use, as required by all Federal, State and Local laws, codes and ordinances?
Yes
No
Other
Do you have a lake, ocean, pond, or river available for guests to use?
Yes
No
Other
Do you have "Swim At Your Own Risk" signs posted?
Yes
No
Other
Is safety (i.e. lifesaving) equipment present, in good working order and available for immediate use, as required by all Federal,State and Local laws, codes and ordinances?
Yes
No
Other
Do you have any diving boards?
Yes
No
Other
Do you have a slide?
Yes
No
Other
If renters are not allowed to use water amenities:Do you have "No Swimming" signs posted near water?
Yes
No
Other
Do You Have a Dock?
Yes
No
Do You Host Special Events?
Yes
No
How Many Special Events and what type are planned for this upcoming year?
Do you require the event host to obtain special event insurance and list you as additional insured?
Do you obtain certificates of insurance from vendors?
Do you provide any service such as catering during special events?
Do You Own Any Vacant Land in Conjunction with Your Vacation Rental?
Yes
No
How Many Parcels of Vacant Land?
Do You Have a Centrally Monitored Burglar System?
Yes
No
Do You Have a Centrally Monitored Fire Alarm?
Yes
No
Do Any of Your Buildings Have Aluminum Wiring, Fuse Boxes or Knob and Tube Wiring?
Yes
No
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Do You Serve Any Alcohol at Your Vacation Rental?
Yes
No
Please Describe
Does the Named Insured Operate any other Business Activity, on or off Premise, other than Short-Term Vacation Rentals?
Yes
No
Please Describe
Do You Have any Employees or any Paid Staff, Related to this Vacation Rental Property? (This Does Not Include a Contracted Property Management Company and/or Incidental Workers)
Yes
No
Please Describe
Have You or any other Owner of the Vacation Rental Business Filed for Bankruptcy in the Last 7 Years?
Yes
No
Please Describe (Include Dates and if Bankruptcy has Been Discharged)
Has Anyone with a Financial Interest in the Vacation Rental Property Been Convicted of Arson, Fraud or any Crime Related to the Loss of Property?
Yes
No
Do you own any vacant land in conjunction with your vacation rental?
Yes
No
If yes, please provide address or legal description of vacant land along with the number of parcels.
Are you in the Process of Purchasing this Property?
Yes
No
When did you Purchase the Property? (Year)
When did the Property become a Vacation Rental? (Year)
When do you Anticipate Closing on this Property?
-
Month
-
Day
Year
Date
Do you Currently have Insurance on this Property?
Yes
No
Insurance Company
Has your Insurance been Declined, Cancelled, or Non-Renewed for any Reason other than Being a Vacation Rental?
Yes
No
Please Describe
Is the Home Located Outside of City Limits?
Yes
No
Unknown
Name of Responding Fire Department
Distance to Fire Hydrant (Feet)
0-1000 ft
Over 1000 ft
None
Unknown
What Steps have you Taken to Minimize the Risk of Wildfires and Wildfire Damage to your Property?
Do you Own, Rent or Lease the Vacation Rental Property?
Own
Rent or Lease
Does your Lease Agreement Clearly State you are Allowed to Sublease as a Short term Rental?
Yes
No
Does your lease Agreement Require you to Carry Coverage to Rebuild the Structure?
Yes
No
Do you Allow any Long Term Rentals? (i.e more than 6 months)
Yes
No
Are your Renters Required to Sign a Lease Agreement, Physically or Electronically, Prior to Occupying this Vacation Rental Property?
Yes
No
Is the Named Insured the Deeded Owner of the Property?
Yes
No
Name of Individual or Entity who is Deeded Owner of Property
First Name
Last Name
Address of Individual or Entity who is Deeded Owner of Property
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
At this Location, do you Control Direct Access to Water, Including Pool, Spa, Hot Tub, Lake, Ocean, River or Pond?
Yes
No
Check all that Apply
Pool
Spa or Hot Tub
Lake, Ocean, Pond or River
Do you Provide any Amenities to your Guests?
Yes
No
Select all that Apply
ATVs
Bikes
Boats (Canoes, Kayaks, paddle Boats, etc.)
Exercise Equipment
Golf Carts
Horses or Horse Facilities
Hunting
Sauna
Trams
Trampolines
Zip Lines
Other
Other than Domesticated Dogs or Cats, are there any other Animals on the Premise?
Yes
No
Please Describe
Do You Rent RV Pads or RV Hook-Ups to Others?
Yes
No
How Many RV Sites are Available to Rent?
At any one Time do you Allow Multiple Renters to Bring their own RV's onto the Premise?
Yes
No
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Next
Within the Next Year do you Plan to do any Construction or Renovation Work at this Vacation Rental Property?
Yes
No
Please Describe the Renovations
Have you Hired a Contractor to Begin the Work?
Yes
No
When do you Plan to Start the Renovations?
-
Month
-
Day
Year
Date
When is your Expected Completion?
-
Month
-
Day
Year
Date
Is a Post-Stay Inspection Completed by an Individual such as: Owner, Manager, Cleaning Crew, Caretaker or Property Manager after each Renter Leaves?
Yes
No
Please select items included on the post stay inspection checklist:
All windows are closed and locked
All smoke detectors are visually inspected to confirm they are operational
All carbon monoxide detectors are operational
Confirm there are no water leaks
Batteries in smoke detectors and carbon monoxide detectors are replaced every six months
How Long after the Renter Leaves this Vacation Rental property is the Post-Stay Inspection Completed?
24 Hours
24-48 Hours
More Than 48 Hours
Do you Keep a Copy of Each Post-Stay Inspection Finding on File for at Least a Year?
Yes
No
Is Emergency Information (i.e 911, Vacation Rental's Address, and either your Phone Number or the Property Manager's Phone Number) Clearly Posted Near a Centrally Located Phone or Primary Exit?
Yes
No
Are Portable fire Extinguishers Located Near all Cooking Areas, Fireplaces, Wood Burning Stoves and Outdoor Fire Pits?
Yes
No
Within the Last 3 Years, has this Vacation Rental Property had any Local Code or Ordinance Violations?
Yes
No
Please Describe
When was the Last Violation Reported?
-
Month
-
Day
Year
Date
Have all Violations been Resolved?
Yes
No
Please Explain
Is There a Backup Generator Located at this Vacation Rental Property?
Yes
No
Is the Generator at least 20 feet Away from all Windows and Vents?
Yes
No
Are there any Docks at the Location?
Yes
No
How Many?
Are there any Portable Space Heaters Located at this Vacation Rental Property?
Yes
No
Are they used as a Primary Source of Heat?
Yes
No
If they are Open Flame or Kerosene Units, are they Bolted Down and do they have a Thermostat?
Yes
No
N/A
Do you have any Unlocked or Unsecured Firearms Located at this Vacation Rental Property?
Yes
No
Is this Vacation Rental Property ever Vacant (i.e not occupied by you or a renter) During the Winter Months?
Yes
No
Please Describe Your Weatherization Procedures
What Type of Building is the Structure?
Square Footage
How Many Bedrooms?
Number of Stories
Is the Structure Listed on the National Register of Historic Places?
Yes
No
What Year was the Building Built?
Building Limits
Content Limits
Loss of Income Limit 50
Do you have any Fireplaces or Heating Stoves?
Yes
No
Check all that Apply
Wood Burning Stove/Fireplace
Gas Stove/Fireplace
Pellet stove
Ventless Fireplace
Is there an Operational Smoke Detector Located in Each Hallway, Stairwell, and Bedroom?
Yes
No
Is there an Operational Carbon Monoxide Detector Located on Every Floor with a Bedroom and/or in any Bedroom Located Above a Garage?
Yes
No
Is the Home Equipped with a Fire Suppression System (i.e fire sprinklers)
Yes
No
Do you Have a Water Leak Detection System Installed in the Home?
Yes
No
Does it Automatically Turn off the Water if a Leak is Detected?
Yes
No
What is the Roof Material?
Has the Roof Been Completely Replaced?
Yes
No
Year the Roof was Replaced
Is the Roof Still Under Manufacturers Warranty?
Does this Building have Electrical, Plumbing, or Heating Utilities Installed?
Yes
No
Check all that Apply
Electrical
Plumbing
Heating
Has the Electrical System been Completely Replaced?
Yes
No
What Year was it Replaced?
Has the Plumbing System been Completely Replaced?
Yes
No
What Year was the Plumbing System Completely Replaced?
Has the Heating System been Replaced?
Yes
No
What Year was the Heating Replaced?
What Type of Heating System is Installed in the Building?
Forced Air Gas
Forced Air Electric
Electric Baseboard
Boiler
Multiple Types
Other
Please Describe
How do you Advertise this Building for Rent?
Online Listing Site
Property Manager Website
I do not advertise online
Other
Name of Site or Web Address of Online Listing
If Known Provide your Online Listing Number or Name of Rental
Please Describe
Do you Have any of the Following Additional Interests- Additional Insured, Loss Payee, Mortgagee?
Yes
No
Choose a Liability Limit Option
$1M Occurrence/$2M Aggregate
$2M Occurrence/ $3M Aggregate
Choose a Deductible for your Property Coverage
$2,500
$5,000
$10,000
$25,000
Would you Like to Purchase Bed Bug Clean Up Coverage of $15,000?
Yes
No
Would You Like to Purchase Building Ordinance Coverage?
Yes
No
Please Select One
CovrgeA:Full Building limit/CovrgeB:10% of Building Limit/CovrgeC 10% of Building Limit
Coverage A: Full Building limit/Coverage B & C: 10% of building limit
Is one of the Properties you Provided your Primary Residence?
Yes
No
Street Address of Primary Residence
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Are there any additional interests?
Yes
No
Additional Interest
First Name
Last Name
Additional Interest
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please describe this entity's interest in the designated property
Interest in Premise Number
-
Area Code
Phone Number
Select all that apply
Additional Insured
Loss Payee
Mortgagee
Do You Wish to Purchase Coverage for Acts of Terrorism for an Additional Premium?
Yes
No
Submit
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