Commercial Property/Liability Insurance

Location # 1
Name*
Physcial Location Address
Street Address City State ZIP Code
Square Footage of Building*
Age of Building/ Year Built*
Construction*
- Frame
- Joisted
- Masonry
- Metal
# of Stories*
# of Units*
Occupancy*
- Apartment
- Condo
- Du-Plex
- Commercial
Limits of Liability*
- $1,000,000/$2,000,000
- $2,000,000/$4,000,000
Building Limit*
Roof Type*
- Asphalt
- Clay
- Membrane
- Shake
Valuation of Building*
- Replacement Cost
- ACV
Historical Building/Area*
- Yes
- No
Parking under building*
- Yes
- No
If Yes*
- First Story
- Subterranean
If Yes; Sq. Ft*
Decks*
- Yes
- No
If Yes, Sq. Ft. of Each*
Total Sq. Ft. of Decks*
Heating Fuel*
- Gas
- Electric
Hot Water Heater*
- Yes
- No
If yes, where are they located:*
Is the Water Heater Strapped?*
- Yes
- No
Type of Water Heater*
- Gas
- Electric
Smoking Allowed*
- Yes
- No
If Yes, Describe Controls*
Building Updates
Updates*
Type Date

Please add all types and dates for the items that have been updated. Examples of types of updates - Electrical, Plumbing, Heating, Roof, Circuit Breakers, Fuses, Copper, PVC, Steel, Copper, Alluminum.
Comments Regarding Updates:
Note: Attach current policy declaration page and carrier loss runs if available
File
Accepted file types: jpg, gif, png, pdf, Max. file size: 64 MB.

Location # 1

Type	Date