LPI Homeowner's Discount Questionnaire

LPI Homeowner's Discount Questionnaire
Name:
Tel.
Email:
Address of Insured Property:
Are Any of the Following Devices installed on Property:
Alarm System

YesNo
Install Date:

MonthDayYearHourMinutesAM/PM Option
Backwater Valve

YesNo
Install Date:

MonthDayYear
Alarmed Sump Pump (ASP):

YesNo
Install Date

MonthDayYear
Does ASP have Battery BackUp?

YesNo
Automatic Water Shut-Off System

YesNo
Install Date:

MonthDayYear
When was your Hot Water Tank last Replaced:

MonthDayYear
Is your Hot Water Tank Tankless:

YesNo
When was your Roof last Replaced?

MonthDayYear
Does Property Sit on a Septic Field?

YesNo
Does Property have an Unfinished Basement:

YesNo
What kind of Siding does Property have on Exterior? (%)
Please list all types of siding and percentage of cover for each:
%
%
%
Does your property have a Mortgage or Line of Credit?

YesNo
If Yes, Please Name Lender(s) and Provide Amount(s)
Are You willing to provide your insurer with a Credit Score Consent?

YesNo
Should be Empty: