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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 until you receive written notice. You also agree to release us from any liability if this information is accidentially viewed by unauthorized others. We will only use this information for insurance quoting purposes and not distribute to other parties.
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Copyright © 2006 Lewis Insurance All Rights Reserved. We are licensed in the State of California. License #: 0249600
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