Landlord/Commercial Property Questionnaire
"Be Wise Economize"
Business Name (Legal)
*
I am ready to take FORDNS FOR INTERNAL USE ONLY
I am ready to take FORDNS
What type of entity are you?
*
LLC
INC
Sole proprietorship
Doing Business As Name ( If Applicable)
*
First Name
*
First Name
Last Name
Cell Phone Number
*
Please enter a valid phone number
Format: (000) 000-0000.
EIN Number or equivalent if a sole proprietor.
*
Your Date of Birth
Please select a month
January
February
March
April
May
June
July
August
September
October
November
December
Month
Please select a day
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Day
Please select a year
2026
2025
2024
2023
2022
2021
2020
2019
2018
2017
2016
2015
2014
2013
2012
2011
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001
2000
1999
1998
1997
1996
1995
1994
1993
1992
1991
1990
1989
1988
1987
1986
1985
1984
1983
1982
1981
1980
1979
1978
1977
1976
1975
1974
1973
1972
1971
1970
1969
1968
1967
1966
1965
1964
1963
1962
1961
1960
1959
1958
1957
1956
1955
1954
1953
1952
1951
1950
1949
1948
1947
1946
1945
1944
1943
1942
1941
1940
1939
1938
1937
1936
1935
1934
1933
1932
1931
1930
1929
1928
1927
1926
1925
1924
1923
1922
1921
1920
Year
Mailing Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Email
*
example@example.com
How did you hear about us
*
What are your projected gross sales a year
*
Location 1 Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
What year was the roof updated?
*
What year was the plumbing updated?
*
What year was the heating and cooling updated?
*
What year was the electrical updated?
*
Construction type?
*
Block
Frame
Block down stairs and Frame Up stairs
For Internal use only Comment box FORDNS and to Do list
Do you have a second Property you need coverage for?
*
Yes
No
Location 2 Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
What year was the roof updated?
*
What year was the plumbing updated?
*
What year was the heating and cooling updated?
*
What year was the electrical updated?
*
Constructin type?
*
Block
Frame
Block down stairs and Frame Up stairs
I would like a quote on the following coverage ( Check all that apply)
*
Dwelling
Liability
Contents inside the home/commercial property
Business income
Other structures (sheds, fence ETC)
If you need contents coverage please choose how much
*
Search
10,000
20,000
30,000
50,000
100,000
200,000
Call me I need to disuss this
NONE
Please Select
Would you like a quote on your home or auto insurance for a potention discount?
*
Yes
no
Does this qualify for a BOP policy (For internal purposes only)?
Yes
No
What is your home address?
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
I opt in to receive text and email *
*
Yes
No
Submit
Should be Empty: