• OTHER SERVICES SUPPLEMENT

    OTHER SERVICES SUPPLEMENT

    Real Estate Professionals Errors and Omissions Insurance Application

  • Please complete only the sections that apply to services performed by the Applicant or any insured.

  • Is the applicant engaged in Property Management?*

  • Section 1: Property Manager Information

  • 1. Does the Applicant enter into a contract with each property owner?*
  • 2. Is a budget prepared for each property managed?*
  • 3. Are standard management and lease agreements used for all properties?*
  • 4. Does the Applicant hire licensed contractors to provide services for any managed properties?*
  • If Yes, does the applicant require certificates of insurance from each contractor?
  • 6. Does the Applicant require liability insurance to be in place for all properties managed?*
  • 8. Do all your property managers have 3+ years of experience in property management services?*
  • 9. Do you perform inspections, at least annually, on each property managed?*
  • 10. Are you listed as Additional Insured on the landlord’s policy?*
  • 11. Does the applicant have procedures to handle compliance with Federal, State and Local statutes involving evictions?*
  • 12. Are attorneys used for all evictions?*
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  • 14. Does the Applicant have ownership interest in any properties managed?*
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  • *Property Type categories include: single family homes, 1-4 unit apartment buildings, 5+ unit apartment buildings, HOAs, office buildings, commercial properties, shopping centers, or "other." 

  • Is the applicant engaged in Mortgage Brokering?*

  • Section 2: Real Estate Mortgage Broker Information

  • 2. In transactions where the Applicant serves as both the real estate agent/broker and the mortgage broker, does the Applicant inform the client that they are under no obligation to use the Applicant’s mortgage broker services?*
  • a. Are licenses held in all states where required by law?*

  • 4. Please provide the following, for the past 12 month period:

     

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  • 5. Indicate the percentage of loans which are:

  • 6. What percentage of your loans:

  • 7. Have you in the past, or do you now:

  • a. Perform underwriting duties?*
  • b. Provide loan servicing duties?*
  • c. Have any discretionary loan making authority?*
  • d. Solicit investors or use your own capital in loans you broker?*
  • e. Fund any loans via a warehouse line of credit or other means in your own name?*
  • f. Perform appraisals on properties you provided mortgage brokering services for?*
  • g. Have a correspondent relationship terminated by an investor?*
  • h. Close or fund any loans without having advance written commitment from an investor or bank to purchase the loan?*

  • If you answered YES to any of the above (7. a-h), please explain on a separate paper on company letterhead (upload below).

  • 8. Have any allegations been made against you for violations of the Truth-In-Lending Act, the Equal Credit Opportunity Act, or the Real Estate Settlement Procedures Act?*

  • If you answered YES, please explain on a separate paper on company letterhead, and upload below.

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  • Section 3: Wire Transfer Information

  • 1. Does the applicant maintain a separate in-force Cyber Liability Policy, Crime Policy or Fidelity Bond?*
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  • 2. Do you provide or accept funds transfer instructions via telephone, e-mail, text message or similar method of communication?*

  • If you provide or accept funds transfer instructions via telephone, e-mail, text message or similar method of communication, the following questions are required:

  • a. If Yes to #2, indicate which of the following procedures are implemented PRIOR to initiating any financial transaction.*
  • If you require receipt of a code or password, has the actual code ever been included in an e-mail communication?
  • b. Are all changes to client accounts confirmed by using existing contact information PRIOR to making any changes to account information?*
  • c. Is approval by more than one person required to initiate a wire transfer?*
  • 3. Are all staff and professionals provided with Anti-Fraud Training specific to socially engineered fraud?*
  • 4. Have you received any fraudulent e-mail or other communication in the past 12 months purporting to be from a customer, vendor, supplier, business partner or employee indented to direct a transfer of funds in your possession?*
  • Is the applicant engaged in Appraisals?*

  • Section 4: Real Estate Appraiser Information

  • 3. Are written agreements between the Applicant and the bank or financial institution in place that outline the duties of the appraiser and the fees charged for such services?*
  • 4. Does the Applicant always use standard appraisal forms that comply with USPAP?*
  • 5. Does the Applicant perform any Right-of-Way appraisals?*

  • If Yes, please provide the revenue and number of transactions for the past 12 months:

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  • Is the applicant engaged in Auctions?*

  • Section 5: Real Estate Auctioneer Information

  • 1. Does the Applicant provide any written guarantee relating to the condition of the properties being auctioned?*
  • 2. Does the Applicant always put the properties to be auctioned on display for inspection prior to the auction?*
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  • Is the applicant engaged in Construction/Development?*

  • Section 6: Construction/Development Ownership Interest Information

  • 1. Has the Applicant, or any of its agents, sold or listed for sale any properties that were developed or constructed by a separate business entity owned by the firm, any of its agents or the spouse or domestic partner of an agent or owner?*

  • If Yes, please provide the following:

  • g. Types of properties developed or constructed by the business entity:*

  • 2. For the past 12months, please provide the amount of gross commission income (GCI) derived from the sale of properties associated with the separate business entity described in question 2 above:

  • 3. During the past 5 years has the Applicant or any of its agents:

  • a. Had any claims made against them involving the entity mentioned in question 1a. above?*

  • If Yes to 3. a., please complete a Claim Supplement for all claims. Click here for the CLAIM SUPPLEMENT

  • b. Have knowledge of any act or omissions which might reasonably be expected to be the basis of a claim against them involving the entity mentioned in question 1a. above?*
  • Is the applicant engaged in Business Brokering?*

  • Section 7: Business Brokerage Information

  • This section must be completed if coverage for the sale of Business Opportunities is requested. All questions must be answered completely.

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  • 2. Is the Applicant, or the agent or broker responsible for the sale of the business, involved in the valuation of the business being sold?*
  • 3. Does the Applicant disclose to the purchaser in writing that there is no certainty or assertion of any future business value or income?*

  • Please provide a copy of the standard disclosure form and any other forms, waivers or disclosures used by the Applicant during the negotiation and sale of Business Opportunities.

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  • 4. Does Applicant provide a written recommendation that each party retain an attorney and an accountant for the purpose of performing a due diligence review; including evaluation of the income, expenses and feasibility of the sale/purchase of the business operations?*
  • 5. Does Applicant have a written policy prohibiting agency personnel from making recommendations regarding attorneys and accountants selected?*

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    FRAUD WARNING: Any person who knowingly and with intent to defraud any insurance company or other person files an application for insurance or statement of claim containing any materially false information or conceals, for the purpose of misleading, information concerning any fact material thereto commits a fraudulent insurance act, which is a crime and subjects such person to criminal and civil penalties.

    FLORIDA FRAUD WARNING: Any person who knowingly and with intent to injure, defraud or deceive any insurer, files a statement of claim or an application containing any false, incomplete, or misleading information is guilty of a felony of the third degree.

    KANSAS FRAUD WARNING: A "fraudulent insurance act" means an act committed by a person who, knowingly and with intent to defraud, presents, causes to be presented ot prepares with knowledge or belief that it will be presented to an insurer, purported insurer, broker or any agent thereof, any written, electronic electronic impulse, facsimile, magnetic, oral, or telephonic communication or statement as part of, or in support of, an application for the issuance of, or the rating of an insurance policy for personal or commercial insurance, or a claim for payment or other benefit pursuant to an insurance policy for commercial or personal insurance which such person knows to contain materially false information concerning any fact material thereto; or conceals, for the purpose of misleading, information concerning any fact material thereto.

    MAINE FRAUD WARNING: It is a crime to knowingly provide false, incomplete or misleading information to an insurance company for the purpose of defrauding the company. Penalties may include imprisonment, fines or denial of insurance benefits.

    MARYLAND FRAUD WARNING: Any person who knowingly or willfully presents a false or fraudulent claim for payment of a loss or benefit or who knowingly or willfully presents false information in an application for insurance is guilty of a crime and may be subject to fines and confinement in prison.

    OREGON FRAUD WARNING: Any person who knowingly and with intent to defraud any insurance company or other person files an application for insurance containing any materially false information or conceals, for the purpose of misleading, information concerning any fact material to the content of the contract commits a fraudulent insurance act, which may be violating state law and may be subject to prosecution for insurance fraud.

    I understand that the information submitted in this supplementalquestionnairebecomes a part of myReal Estate ProfessionalsErrors&OmissionsInsuranceapplication and is subject to the samerepresentations and conditions.

  • SIGNATURE PAGE

  • After signing, you must click the green button below to submit your supplemental application.

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