TRF Property Investor Insurance
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Entity/Borrower Details
Estimated Effective Date
*
-
Month
-
Day
Year
Entity/Borrower Name
*
ex. LLC, S Corp, Sole Proprietorship
Contact Name
*
First Name
Last Name
Entity/Borrower Mailing Address
*
City
*
State
*
Please Select
AK
AL
AR
AZ
CA
CO
CT
DC
DE
FL
GA
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MI
MN
MO
MS
MT
NC
ND
NE
NH
NM
NV
NJ
NY
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VA
VT
WA
WI
WV
WY
Zip
*
Phone
*
Please enter a valid phone number.
Entity/Borrower Email
*
example@example.com
Loan Officer Email
*
example@example.com
Who should our agency communicate with regarding this insurance quote?
*
Loan Officer
Entity/Borrower
Both
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Claim History
Has THIS PROPERTY had any claims within the last 3 years? (If this is a new purchase, select no)
*
Please Select
Yes
No
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Investment Property Details
Property Street Address
*
City
*
State
*
Please Select
AK
AL
AR
AZ
CA
CO
CT
DC
DE
FL
GA
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MI
MN
MO
MS
MT
NC
ND
NE
NH
NM
NV
NJ
NY
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VA
VT
WA
WI
WV
WY
Zip
*
County
*
Occupancy Type
*
Please Select
Long Term Rental
Short Term Rental
Rehab (Builder Risk)
New Build
New build construction may require additional information. Agent will review and advise.
Briefly describe the rehab scope of work.
*
Rehab properties with major renovations require additional information. Agent will review and advise.
Building Type
*
Please Select
Single Family Residence
Condo
Townhouse
2-4 Unit
Manufactured/Mobile Home
Other
5+ units, mixed use, manufactured/mobile home or other commercial properties may require additional information. Agent will review and advise.
Does the manufactured/mobile home have a skirt?
Please Select
Yes
No
If other, please describe the building type.
*
Construction Type
*
Please Select
Brick Veneer
Joisted Masonry
Wood Frame
Square Footage
*
Monthly Rent (for loss of rental income coverage)
*
Number of Units
*
Please Select
2
3
4
5+
5+ unit properties may require additional information. Agent will review and advise.
Number of Units
Year Built
*
If property is built before 1900, additional review is required by underwriting. Please allow up to 24 hours for a quote.
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Property Condition
Estimated Year of most recent plumbing renovation
*
Estimated Age of roof
*
Properties with roof over 30 years old may require additional information. Agent will review and advise.
Is this property being used as a senior care facility, assisted living facility, hospice care facility, palliative care facility, sobriety and/or drug treatment facility, or home day care facility?
*
Please Select
Yes
No
Specialty care facilities may require additional information. Agent will review and advise.
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Coverage Requests
Policy Term
*
Please Select
6 months
1 year
Building Coverage Amount
*
If building coverage is over $500,000, additional data may be required. Agent will advise.
Loss of Rental Income Calculation:
Contents Coverage (Optional - Owner contents only)
Price Per Sqft Calculation:
Total Insured Value Calculation:
Sewer Backup Coverage (Optional Coverage)
*
Please Select
Yes
No
Ordinance or Law Coverage (Optional Coverage)
*
Please Select
Yes
No
Is insurance escrowed?
*
Please Select
Yes
No
If escrowed, an invoice will be mailed to the lender for payment.
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Lender/Additional Insured Information
Select all that apply
Lender
Additional Insured
Loss Payee
Lender/Mortgagee Clause/Additional Insured
Lender/Additional Insured Mailing Address
City
State
Please Select
AK
AL
AR
AZ
CA
CO
CT
DC
DE
FL
GA
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MI
MN
MO
MS
MT
NC
ND
NE
NH
NM
NV
NJ
NY
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VA
VT
WA
WI
WV
WY
Zip
Lender Contact Name
Lender Email Address
example@example.com
Lender Fax Number
Please enter a valid phone number.
Loan Number
Does the insured and/or entity representing the insured consent to receiving electronic communication from Trinity River Financial Insurance Agency for matters pertaining to their existing or potential insurance policy?
*
Please Select
Yes
No
Submit
Should be Empty: