HOTEL APPLICATION 3/22 EDITION

HOTEL APPLICATION 3/22 EDITION
Full Legal Named Insured
MAILING Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Contact Name

First NameLast Name
Contact Phone Number
Please enter a valid phone number.
SELECT ALL THAT APPLY

Aluminum WiringOccupancy below 60%Armed Security (third party or employees)Hourly RentalsMarinas / Boat Slips / DocksSaddle Animal rentalPolicy been cancelled or non-renewedNamed Insured is in Bankruptcy
Years in Business as current Named Insured (entity formation date)
Years in Hospitality Business
If there any Third Party Contracts in place, please list describe
Do you lease Commercial Space

YesNo
Commercial Space leased Tenant Description & Square Footage

Tenant DescriptionSquare Footage
Rental Spaces for Mobile Homes & Campers

YesNo
If you offer rental spaces for Mobile Homes & Campers, how many of each?

Mobile HomesCampers
Any time Share Units

YesNo
If yes, how many units?
SELECT ALL THAT APPLY - Amenity Rentals

Beach GearPaddle BoardsCanoesPowered WatercraftDay Trips / Excursions
Are you planning any structural renovations?

YesNo
SELECT ALL THAT APPLY

Is there a bar, tavern or lounge selling over 70% receipts AlcoholBeachfrontBoat docks, ramps, slipsConvenience StoreFitness CenterHot Tub (not guest rooms)LakesPlaygroundRestaurant (complete separate application)Sauna / Steam Room
Swimming Pools (if no pool on premises, go to the next question) - Select all that apply

Pool operated on your facilityAnti-Vortex Drain Cover (Virginia Graeme Baker Pool & Spa Safety Act)Depths MarkedRules PostedCompetitionsDiving TeamSwimming InstructionCompletely fenced with self latching gateLife guards on dutyCPR Training for employeesLife Guards contracted out to third partySlides / Diving BoardsFire Extinguishers adequately placed / current service tags
Security Controls - Select all that apply

CCTV public areasPeep Holes in Guest Rooms3rd Party off duty Peace OfficersAdditional Insured Certificates on fileSmoke DetectorsIf yes, batteryor Hard Wired
Gross Hotel Sales (no restaurant sales) projected for next twelve months
Gross Food and Beverage Sales (including alcohol)
Gross Alcohol Sales
Explain all work completed by subcontractors
Select all that apply

Named Insured is Additional Insured on Subcontractors PolicyCertificates of Insurance on file for all vendors
Number of Full Time / Part Time Employees

FULL TIMEPART TIME
Coverage Options - General Liability - Select all you would like proposed

Employee Benefits LiabilityEmployment Practices LiabilityHigh Limits LiabilityIdentity TheftIncrease Medical Expense to $10,000Add Stop Gap Liability
Coverage Options - Property - Select all you would like proposed

Ordinance or Law / Increased Cost of ConstructionEquipment BreakdownProperty Coverage ExtensionsOutdoor signsWater Back Up - Sump Overflow
Should be Empty: