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What's your reason for seeking flood insurance?" * Please select one Buying or recently bought a new building Replacing my existing policy Refinancing a loan New flood map, lender now requires it Just want to have coverage Other (please specify in notes)
What type of entity owns the property? Individual Limited Liability Company (LLC) Corporation Trust Joint Venture Partnership Other (please specify in notes section)
Your Phone Number *
Name of your property management company
Secondary Contact Email Address
Secondary Contact Phone Number
Please Enter Your Local County Name *
What type of property are you looking to insure? * Please select one Office building Mercantile / Retail Restaurant Warehouse Storage Unit Apartment complex or Co-op Building Hotel, Motel or Inn Mixed building Use (residential and something else) Gas station Car wash Commercial Condominiums Manufacturing Entire residential condo building - RCBAP Other
You selected 'Other.' Please describe the type of property you want to insure: *
How is the building primarily used? * Please select one I own it and rent it out to others (not as a residence) I own it and work out of it (not as a residence) I own the entire building of a Apartment or Coop I own a Building that has mixed use some residental some commerical in the same building Renting: contents coverage only. I own a unit in a commercial condominium RCBAP - Entire Residential Condo Building
What is your role in relation to the condo association? * please select one President of the Condo Board Secretary of the Condo Board Treasurer of the Condo Board Board Member Concerned Unit Owner (not on the board) Property Manager Other (please specify) Insurance agent
What is the number of stories in the condo building for which you're seeking a quote? *
Please specify your reason for filling out this form and describe your relationship to the HOA. *
Property Manager Information: The name of your management company: *
Property Manager Information: Your name as the property management representative: *
Property Manager Information: Your phone number for contact: *
Property Manager Information: Your email address for contact: *
How many separate buildings are in the condo complex? *
How many separate buildings are in the apartment complex? *
What is the mixed-use ratio of the building? * please select one 25% Residential, 75% Commercial 50% Residential, 50% Commercial 75% Residential, 25% Commercial
You selected 'Mixed-use' Please describe the type of property you want to insure: *
What year was the building constructed? *
How much coverage do you need for the building itself? * Please select one $100,000 $150,000 $200,000 $250,000 $300,000 $350,000 $400,000 $450,000 $500,000 $600,000 $700,000 $800,000 $900,000 $1,000,000 More then $1,000,000
How much additional building coverage do you require over $1,000,000?
How much coverage do you want for your personal belongings inside (like furniture, electronics, clothing)? * Please select one None $50,000 $100,000 $150,000 $200,000 $250,000 $300,000 $350,000 $400,000 $450,000 $500,000 $550,000 $600,000 $650,000 $700,000 $750,000 $800,000 $850,000 $900,000 $950,000 $1,000,000 More then $1,000,000
How much additional contents insurance coverage do you require over $1,000,000?
How much loss of business income coverage do you want? * Please select one None $50,000 $100,000 $150,000 $200,000 $250,000 $300,000 $350,000 $400,000 $450,000 $500,000 $550,000 $600,000 $650,000 $700,000 $750,000 $800,000 $850,000 $900,000 $950,000 $1,000,000 More then $1,000,000
How much extra business coverage do you require over $1,000,000?
Has the property experienced flood damage? * Please select one No YES I don't know but will ask Seller
What was the total cost of damage, including deductible, contents, and building? *
What type of foundation does your building have? * Please select one Slab Crawl space Split Level Basement Elevated Building
Which description best fits your basement foundation? * Please select one Fully underground on all sides Walkout
Which description best fits your elevated foundation? * Please select one Elevated Open - no enclosure Elevated partially enclosed Elevated with garage ONLY Elevated with a garage and additional room Elevated with the area completely enclosed
Which description best fits your crawl space foundation? * Please select one Crawl space fully or partially underground Crawl space Above ground
What best fits your above ground crawl space? * Please select one Crawl space without enclosure Crawl space partially enclosed Crawl space with enclosure
How many floors 5 or more levels does the building have? *
What is the total square footage of the structure? *
What material is the building's frame constructed from? * Please select one Wood Frame Brick or Masonry Steel Frame Concrete Mobile home with Tie Downs
How is the mobile home secured? * Please select one Anchored per manufacturer's guidelines Anchored to floodplain management standards Secured with ties to ground anchors Not anchored (uninsurable)
What type of garage does the property have? * Please select one No Garage Attached Garage Detached Garage Building over Garage Garage is the basement foundation First floor parking at ground level
How many cars can your garage hold? Please select one 1 2 3 4 5 or more
Does your property have any rooms with floor-to-ceiling wood paneling? * Please select one No, there is no wood paneling. Yes, one small room has wood paneling. Yes, one medium to large room has wood paneling. Yes, two or more rooms have wood paneling.
