Tenant Liability Insurance • California Apartment Association

Applicant Information

Property Name*

Address*

Street Address City State ZIP Code

Manager's Name*

First Last

Email Address

Phone*

Fax

# of Units in property*

Occupancy %*

# of Bldgs*

# of stories*

Year built*

Does the project have any rent regulated units?*

Yes
No

If yes, How many?*

Does the project have any Student Housing units?*

Yes
No

If yes, How many?*

Does the project have any assisted living units?*

Yes
No

If yes, How many?*

Do you obtain Credit Reports for each renter prior to leasing?*

Yes
No

Do you run a Criminal Background Check on all the renters prior to leasing?*

Yes
No

Building construction*

Roof Construction*

Type of Wiring*

Aluminum
Copper

If Aluminum, what % location*

%	Location

Is Aluminum, Updated?*

Yes
No

Sprinklers?*

Yes
No

Where?*

Battery Op Smoke Detectors in all Apts & all Common Areas*

Yes
No

Where?*

Hard Wire Smoke Detectors in all Apts & all Common Areas*

Yes
No

Where?*

Please provide Update year if building is over 15 years old

Plumbing (date)

Roof (date)

Electric (date)

Heat/AC (date)

Other Updates

Yes
No

Please list other updates*

Name	Date

Have you incurred any property losses in the past 3 years?*

Yes
No

If so, Please List the following*

Cause of Loss	Date of Loss	Amount of Loss

*verification of a 3 year loss run from your primary insurance agent MUST accompany this application

File

Accepted file types: jpg, gif, png, pdf, Max. file size: 64 MB.

Pleas upload any and all documents such as verification of a 3 year loss run from your primary insurance agent.

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Applicant Information

Applicant Information