Grand Lodge Insurance Program Questionnaire
Lodge Name and Number
*
Physical Address of Building
*
Age of Building
*
Square Footage of Building
*
Type of Construction
*
Wood Frame
Masonry
Metal
Age of Roof
*
Age of Heating System/HVAC
*
Any Electrical or Plumbing Updates and Dates
*
Do You Have Tenants and What Type of Business are They
*
Do you Have Liquor in the Lodge Hall
*
Yes
No
Submit
Should be Empty: