Home Ins. Purl
This Homeowners PURL is used ot collect risk information for the purpose of quoting. Do not give or share with clients, in house use ONLY.
First Applicant:Â
Second Applicant:
Applicant Address:Â
General Policy Information:
Detached Strucures Information:
Are there any detached structures of any kind on this lot
How many detached structures are there
Underwriting Questions:
Section - Underwriting Questions for 1-4 UnitsÂ
Is the Roof in poor condition or near end of life
Is it a Woodshake Roof
Is the primary heating system powered by other than natural gas and/or electric
How is it powered
Is the electrical system on Fuses
Is the home undergoing any remodling or renovation
Will construction work be completed before the effective date of the new policy
Does the home have a Post and Pier Foundation
Is there a Trampoline on premises?
Anchored to the ground and netted
Are there any farm animals
How many types of farm animals
Is there a swimming pool on the premises
Does it have any of the following
Is the Property currently for sale or planned to be sold in the next 6 months? (By the applicant)*
Is your current/prior policy being canceled for any reason
Are there Dogs on the premises
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Number of dogs
Have you had any homeowner insurance claims in the last 5 years
Number of claims
Section - Underwriting Questions for Condo / Townhome requiring HO6 PolicyÂ
Section - Underwriting Questions for Mobile / Manufactured HomesÂ
Community type location
What is the name of the park
Is there a full time resident manager
Total number of spaces in park
What is the year built
What is the structure type
What is the length
What is the width
Section - Underwriting Questions for Renters requiring an HO4 Policy
Policy Coverage:
Section: (For buildings 1-4 Units)
Section: (For Condo or Townhome Requiring an HO6 Policy)
Section: (For Mobile / Manufactured Homes)
Section: (For Renters requiring an HO4 Policy)
Note: This will transfer the information from this form (Purl) to the matching CPA to help you shop all the carriers and determine the best options.