Apartment Building Insurance Request
contact us at 586-229-1026 | owen@royaloathinsurance.com | If your property consists of more than one building please complete for the main building and indicate there are others in the notes section below. For 1-4 unit properties please visit rentalpropertyinsurancequote.com
Owner/Applicant Name
*
First Name
Last Name
LLC/Trust/Business Entity Name if Applicable
Applicant Date of Birth
*
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Year
Mobile Phone Number
*
Applicant Email
*
example@example.com
Property Address
*
Street Address
Street Address Line 2
City
Please Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Owner Home Address
*
Street Address
Street Address Line 2
City
Please Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Mailing Address (if different than home address)
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Needed Effective Date for New Policy
*
-
Month
-
Day
Year
Date
Estimated Market Value or Purchase Price
*
Year Built
*
Square Footage
*
Construction Type (Visit https://tinyurl.com/4xdtxcw7 for Definitions)
*
Please Select
Frame (including brick veneer)
Joisted Masonry
Non-Combustible
Masonry Non-Combustible
Modified Fire Resistive
FIre Resistive
Roof Type
*
Please Select
Shingle
Built-up (Tar & Gravel)
Rubber Membrane
Metal
Wood Shingles/Shakes
Clay/Concrete Tiles
Other
Electrical Type
*
Please Select
Circuit Breakers
Fuses
Other
Roof Update Year
*
Please estimate if not certain
Electrical Update Year
*
Please estimate if not certain
Heating Update Year
*
Please estimate if not certain
Plumbing Update Year
*
Please estimate if not certain
Type of Foundation
*
Please Select
Unfinished Basement
Finished Basement
Walkout Basement
Crawlspace
Slab
Piers
Other (please indicate in notes)
Total Number of Units
*
Number of Occupied Units
*
Any Student Housing?
*
Please Select
Yes
No
Any retail or office exposure?
*
Please Select
Yes
No
Any Subsidized Housing?
*
Safety Features (select all that apply)
*
Hardwired Smoke Detectors
Battery Powered Smoke Detectors
Automatic Fire Sprinkler
Monitored Fire Alarm
Local Fire Alarm
Carbon Monoxide Detectors
Occupancy Type
*
Please Select
Long Term Rental (annual leases)
Medium Term Rental (under 1 year)
Short Term Rental (under 30 days allowed)
Mixture
Mortgage?
*
Please Select
Yes
No
Current Insurance Carrier (indicate if new purchase or explanation if no coverage or non-renewal)
*
Property Insurance Claims in last 5 Years?
*
Please Select
No
Yes (please add notes)
Annual Rental Receipts
*
Do you require renters insurance in your leases?
*
Please Select
Yes
No
We strongly recommend that you do!
Are you using a 3rd-Party Property Manager?
*
Please Select
Yes
No
Please upload current insurance declaration pages or other documents such as a property inspection and photos if available
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