Real Estate Property Investor Application
Investor Details
Estimated Effective Date
*
-
Month
-
Day
Year
Investor Name
*
ex. TRF, LLC
Contact Name
*
First Name
Last Name
Investor 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.
Format: 000-000-0000.
Investor Email (Quote and all correspondence will be sent to the investor's email)
*
example@example.com
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Claim History
Have you had any claims on THIS PROPERTY within the last 3 years? (If this is a new purchase or new build, select no)
*
Please Select
Yes
No
Please upload a loss run report for this property.
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Is this property within 2 miles of saltwater?
*
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
Rental
Rehab (Builder Risk)
New Build
Vacant
New build construction may require additional information. Agent will review and advise.
Is the property at full or partial occupancy?
Please Select
Full Occupancy
Partial Occupancy
Is this rehab Major or Minor?
Please Select
Major
Minor
ex. Major - moving load-bearing walls or adding sqft to foundation Minor - cosmetic updates
Briefly describe the rehab scope of work.
*
Rehab properties with major renovations require additional information. Agent will review and advise.
Please provide formal scope of work with budget breakdown to be reviewed by underwriting.
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Estimated project completion date
-
Month
-
Day
Year
Contractor's Name
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
Number of Stories
*
Please Select
1
2
3
Square Footage
*
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.
If the property is built before 1900, please provide images of all 4 sides.
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Property Condition
Year of most recent plumbing renovation
*
Was the plumbing renovation partial or complete?
*
Please Select
Partial Renovation
Complete Renovation
N/A
Year of most recent roof renovation
*
Was the roof renovation partial or complete?
*
Please Select
Partial Renovation
Complete Renovation
N/A
Is the electrical on Circuit Breakers?
*
Please Select
Yes
No
Year of most recent electrical renovation
*
Was the electrical renovation partial or complete?
*
Please Select
Partial Renovation
Complete Renovation
N/A
Year of most recent heating renovation
*
Was the heating renovation partial or complete?
*
Please Select
Partial Renovation
Complete Renovation
N/A
Heating Type?
Please Select
Gas
Electric
Do any of the following apply to this location? (select all that apply)
*
Boat Dock of Slip
Hot Tub
Lake
Pond
Reservoir or other Body of Water
Playground or Park
Sports Court or Filed
Swimming Pool
Trampoline
None of the above
Is the pool in-ground or above ground?
Please Select
In-Ground
Above Ground
Is there a sprinkler system?
*
Please Select
Yes
No
Is there a fire extinguisher?
*
Please Select
Yes
No
Is there damage to the property?
*
Please Select
Yes
No
For vandalism & malicious mischief and theft coverage to apply, property must be secured regardless of occupancy/rehab status and must have four walls, a roof and doors that can be locked.
The policy has a pre-existing damage exclusion and coverage will not be provided for any pre-existing damage. Does the investor accept the pre-existing damage terms and conditions?
Please Select
Yes
No
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 - Rental
*
Please Select
6 months
1 year
Policy Term - Rehab
*
Please Select
6 months
9 months
1 year
Policy Term - New Build
Existing Building Coverage Amount
Renovations Cost
Building Coverage Amount
*
Loss of Rental Income Coverage
Contents Coverage (Owner contents only)
Sewer Backup Coverage (Optional Coverage)
*
Please Select
Yes
No
Ordinance or Law Coverage (Optional Coverage)
*
Please Select
Yes
No
Do you have a lender?
*
Please Select
Yes
No
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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.
Format: 000-000-0000.
Loan Number
Do you the investor/insured consent to receiving electronic communication from Trinity River Financial Insurance Agency for matters pertaining to your existing or potential insurance policy?
*
Please Select
Yes
No
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Please provide any additional information applicable to this submission.
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