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Apartment Building Owner & Owners Insurance Quote
First & Last Name:
Location Street Address:
City, State & Zip:
E-Mail Address:
Telephone:
Fax:
Business Name:
Insurance Company Name:
Policy Exp. Date:
Any Claims in Last 3 years?
(if Yes, please describe)
Do you carry work comp for your managers?
Yes
No
Year Property Built:
Any Updates to Property?
(if Yes, please describe)
Complete Lender Info.
ie Escrow Info if new purchase
Apartment Information
Apartment Units:
How many Stories?:
# of buildings:
Flood Insurance?
Yes
No
Any Pools?
Yes
No
Construction Type:
Total Sq. Ft. of building (s):
Earthquake Insurance?
Yes
No
(if Yes, what type of parking?)
Please give any additional information that might be helpful in providing you an accurate apartment owners insurance quote:
Note: By submitting this form you understand that no coverage is bound unitl you receive written notice.
©2005 Copyright Dimond Bros. Agency, Inc. All Rights Reserved
Headquarters: 111 Sheriff St., P.O. Box 1090, Paris, IL 61944 217-465-5041 voice / 217-463-3809 fax