Tenant Insurance Self-Storage Facility Application

TENANT INSURANCE PROGRAM*

Pay-With-RentTenantOne Direct
FACILITY INFORMATION
Name and address of self-storage facility:
Facility Name:*
Manager's Name:*
E-Mail Address:*
Web Site Address:
Telephone:*
FAX:*
Facility Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Same address as above
Mailing Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Same address as above
Parcel Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Name and address of facility owner:
Facility Owner Name:
Telephone:*
FAX:
Mailing Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Name and address of management company, if applicable:
Management Company:
Telephone:
FAX:
Contact Person:
Mailing Address:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

* INSURANCE INFORMATION
Number of losses in the past three years caused by:
Break-ins:*
Water damage:*
Fire:*
Other:*
Do you currently offer tenant insurance?*

YesNo
Name of company providing your tenant insurance:
Number of insured customers:
Name of insurance agency who handles your commercial insurance coverage:
Name of insurance carrier who provides your commercial insurance coverage on the property/buildings:
When does that insurance expire:

IMPORTANT INFORMATION ABOUT MINICO TENANT INSURANCE OWNERS/OPERATORS: PLEASE READ CAREFULLY, CHECK THE BOX IN EACH SECTION TO ACKNOWLEDGE CERTIFICATION, AND CLICK "SUBMIT" WHEN COMPLETED.--------------------------------------------------- PROTECTION FOR YOUCustomers insured by MiniCo tenant insurance are less likely to seek legal action against you should they suffer a loss. Inside each MiniCo tenant insurance brochure/application is a Tenant Responsibility Addendum reinforcing the provisions of your lease and bringing your customers’ attention to the fact that your facility is not responsible for loss or damage to goods in storage. The Addendum also provides proof that you gave an insurance brochure/application to your customers.
I certify that the manager of this facility will be instructed to hand out a MiniCo tenant insurance brochure/application and review the Tenant Responsibility Addendum with the customer at the time any lease is signed.*

Yes
PEACE OF MIND FOR CUSTOMERSThe MiniCo tenant insurance brochure/application reminds customers that they must provide their own insurance.
I certify that the manager will be instructed to explain to new customers the following three conditions: 1. Facility is not responsible for the loss of or damage to customers’ property. 2. Facility does not provide insurance on customers’ property. 3. Customer may obtain insurance under this optional program.*

Yes
I CERTIFY THAT THE INFORMATION I HAVE PROVIDED HEREIN IS CORRECT:*

Yes
Should be Empty: