Single Family Rental Dwelling Insurance Quote

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Julie Johnson Sanabria

Sales Executive
Phone: 770-718-5121
Email Julie

Julie Johnson Sanabria

Sales Executive
Phone: 770-718-5121
Email Julie

Please Complete the Form Below:

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Step 1 of 16

Name/Entity*

Contact Name (if different from above)

First Last

Contact Phone Number*

Contact Email*

Property List

Number of Properties to be Insured*

Target Policy Effective Date*

MM slash DD slash YYYY

Property #1

Property #1 Address*

Street Address Address Line 2 City State ZIP Code

County*

Property #1 Information

Requested Coverage Amount - Dwelling*

Requested Coverage Amount - Loss of Rental Income*

Square Footage*

Property Type*

If Other, please specify property type below:

Property Use*

If Other, please specify property use below:

Are you planning any renovations to the property within the next 12 months?*

Yes

Renovation Type*

Property Construction Type*

Year Built*

Year of Most Recent Electrical Renovation*

Is the Electrical on Circuit Breakers?*

Year of Most Recent Roof Renovation*

Age of Roof in Years*

Year of Most Recent Plumbing Renovation*

Year of Other Major Upgrades/Renovations*

Section 8 Housing*

Student Housing*

Is there a pool on the property?*

Is There Any Exisiting Damage to the Property*

Is this property currently Tenant-Occupied or is it Vacant (not expected to be rented for at least 30 days)?*

Has this property sustained 3 or more claims or any non-weather related damage in excess of $10K in the past 3 years?*

Yes

Property #1 Loan & Management

Do you have a loan on this property?*

Yes

Please enter the name of your lender*

Please enter the address of your lender*

Street Address Address Line 2 City State ZIP Code

Lender Phone Number*

Loan Number*

Is this property managed by a 3rd party property manager?*

Yes

Property Management Company*

Property Management Company Address*

Street Address Address Line 2 City State ZIP Code

Property Management Company Phone*

Contact Name*

First Last

Property #1 Tenant Information

Do tenants go through background checks?*

Select all that apply

Criminal

Credit

Tenant Eviction

Income

Are tenants required to have renters insurance?*

Yes

Are tenants allowed to have dogs?*

Yes

Property #2

Property #2 Address*

Street Address Address Line 2 City State ZIP Code

County*

Property #2 Information

Requested Coverage Amount - Dwelling*

Requested Coverage Amount - Loss of Rental Income*

Square Footage*

Property Type*

If Other, please specify property type below:

Property Use*

If Other, please specify property use below:

Are you planning any renovations to the property within the next 12 months?*

Yes

Property Construction Type*

Year Built*

Year of Most Recent Electrical Renovation*

Is the Electrical on Circuit Breakers?*

Year of Most Recent Roof Renovation*

Age of Roof in Years*

Year of Most Recent Plumbing Renovation*

Year of Other Major Upgrades/Renovation*

Section 8 Housing*

Student Housing*

Is there a pool on the property?*

Is There Any Exisiting Damage to the Property*

Is this property currently Tenant-Occupied or is it Vacant (not expected to be rented for at least 30 days)?*

Has this property sustained 3 or more claims or any non-weather related damage in excess of $10K in the past 3 years?*

Yes

Property #2 Loan & Management

Do you have a loan on this property?*

Yes

Please enter the name of your lender*

Please enter the address of your lender*

Street Address Address Line 2 City State ZIP Code

Lender Phone Number*

Loan Number*

Is this property managed by a 3rd party property manager?*

Yes

Property Management Company*

Property Management Company Address*

Street Address Address Line 2 City State ZIP Code

Property Management Company Phone*

Contact Name*

First Last

Property #2 Tenant Information

Do tenants go through background checks?*

Select all that apply

Criminal

Credit

Tenant Eviction

Income

Are tenants required to have renters insurance?*

Yes

Are tenants allowed to have dogs?*

Yes

Property #3

Property #3 Address*

Street Address Address Line 2 City State ZIP Code

County*

Property #3 Information

Requested Coverage Amount - Dwelling*

Requested Coverage Amount - Loss of Rental Income*

Square Footage*

Property Type*

If Other, please specify property type below:

Property Use*

If Other, please specify property use below:

Are you planning any renovations to the property within the next 12 months?*

Yes

Renovation Type*

Property Construction Type*

Year Built*

Year of Most Recent Electrical Renovation*

Is the Electrical on Circuit Breakers?*

Year of Most Recent Roof Renovation*

Age of Roof in Years*

Year of Most Recent Plumbing Renovation*

Year of Other Major Upgrades/Renovation*

Section 8 Housing*

Student Housing*

Is there a pool on the property?*

Is There Any Exisiting Damage to the Property*

Is this property currently Tenant-Occupied or is it Vacant (not expected to be rented for at least 30 days)?*

Has this property sustained 3 or more claims or any non-weather related damage in excess of $10K in the past 3 years?*

Yes

Property #3 Loan & Management

Do you have a loan on this property?*

Yes

Please enter the name of your lender?*

Please enter the address of your lender*

Street Address Address Line 2 City State ZIP Code

Lender Phone Number*

Loan Number*

Is this property managed by a 3rd party property manager?*

Yes

Property Management Company*

Property Management Company Address*

Street Address Address Line 2 City State ZIP Code

Property Management Company Phone*

Contact Name*

First Last

Property #3 Tenant Information

Do tenants go through background checks?*

Select all that apply

Criminal

Credit

Tenant Eviction

Income

Are tenants required to have renters insurance?*

Yes

Are tenants allowed to have dogs?*

Yes

Property #4

Property #4 Address*

Street Address Address Line 2 City State ZIP Code

County*

Property #4 Information

Requested Coverage Amount - Dwelling*

Requested Coverage Amount - Loss of Rental Income*

Square Footage*

Property Type*

If Other, please specify property type below:

Property Use*

If Other, please specify property use below:

Are you planning any renovations to the property within the next 12 months?*

Yes

Renovation Type*

Property Construction Type*

Year Built*

Year of Most Recent Electrical Renovation*

Is the Electrical on Circuit Breakers?*

Year of Most Recent Roof Renovation*

Age of Roof in Years*

Year of Most Recent Plumbing Renovation*

Year of Other Major Upgrades/Renovations*

Section 8 Housing*

Student Housing*

Is there a pool on the property?*

Is There Any Exisiting Damage to the Property*

Is this property currently Tenant-Occupied or is it Vacant (not expected to be rented for at least 30 days)?*

Has this property sustained 3 or more claims or any non-weather related damage in excess of $10K in the past 3 years?*

Yes

Property #4 Loan & Management

Do you have a loan on this property*

Yes

Please enter the name of your lender*

Please enter the address of your lender*

Street Address Address Line 2 City State ZIP Code

Lender Phone Number*

Loan Number*

Is this property managed by a 3rd party property manager?*

Yes

Property Management Company*

Property Management Company Address*

Street Address Address Line 2 City State ZIP Code

Property Management Phone*

Contact Name*

First Last

Property #4 Tenant Information

Do tenants go through background checks?*

Select all that apply

Criminal

Credit

Tenant Eviction

Income

Are tenants required to have renters insurance?*

Yes

Are tenants allowed to have dogs?*

Yes

Property #5

Property #5 Address*

Street Address Address Line 2 City State ZIP Code

County*

Property #5 Information

Requested Coverage Amount - Dwelling*

Requested Coverage Amount - Loss of Rental Income*

Square Footage*

Property Type*

If Other, please specify property type below:

Property Use*

If Other, please specify property use below:

Are you planning any renovations to the property within the next 12 months?*

Yes

Renovation Type*

Property Construction Type*

Year Built*

Year of Most Recent Electrical Renovation*

Is the Electrical on Circuit Breakers?*

Year of Most Recent Roof Renovation*

Age of Roof in Years*

Year of Most Recent Plumbing Renovation*

Year of Other Major Updates/Renovations*

Section 8 Housing*

Student Housing*

Is there a pool on the property?*

Is There Any Exisiting Damage to the Property*

Is this property currently Tenant-Occupied or is it Vacant (not expected to be rented for at least 30 days)?*

Has this property sustained 3 or more claims or any non-weather related damage in excess of $10K in the past 3 years?*

Yes

Property #5 Loan & Management

Do you have a loan on this property?*

Yes

Please enter the name of your lender*

Please enter the address of your lender*

Street Address Address Line 2 City State ZIP Code

Lender Phone Number*

Loan Number*

Is this property managed by a 3rd party property manager?*

Yes

Property Management Company*

Property Management Company Address*

Street Address Address Line 2 City State ZIP Code

Property Management Company Phone*

Contact Name*

First Last

Property #5 Tenant Information

Do tenants go through background checks?*

Select all that apply

Criminal

Credit

Tenant Eviction

Income

Are tenants required to have renters insurance?*

Yes

Are tenants allowed to have dogs?*

Yes

6+ Properties

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6+ Properties Information

Square Footage*

Are you planning any renovations to the property within the next 12 months?*

Yes

Renovation Type*

Property Construction Type*

Year Built*

Year of Most Recent Electrical Renovation*

Is the Electrical on Circuit Breakers?*

Year of Most Recent Roof Renovation*

Age of Roof in Years*

Year of Most Recent Plumbing Renovation*

Year of Other Major Upgrades/Renovations*

Section 8 Housing*

Student Housing*

Is there a pool on the property?*

Is There Any Exisiting Damage to the Property*

Is this property currently Tenant-Occupied or is it Vacant (not expected to be rented for at least 30 days)?*

Has this property sustained 3 or more claims or any non-weather related damage in excess of $10K in the past 3 years?*

Yes

Property #6 Loan & Management

Do you have a loan on this property?*

Yes

Please enter the name of your lender*

Please enter the address of your lender*

Street Address Address Line 2 City State ZIP Code

Lender Phone Number*

Loan Number*

Is this property managed by a 3rd party property manager?*

Yes

Property Management Company*

Property Management Company Address*

Street Address Address Line 2 City State ZIP Code

Property Management Company Phone*

Contact Name*

First Last

Property #6 Tenant Information

Do tenants go through background checks?*

Select all that apply

Criminal

Credit

Tenant Eviction

Income

Are tenants required to have renters insurance?*

Yes

Are tenants allowed to have dogs?*

Yes

During the last 5 years have you had a foreclosure, repossession, bankruptcy, or filed bankruptcy?*

Yes

During the last 5 years have you been indicted for or convicted for any degree of the crime of fraud, bribery, arson or any other arson-related crime in connection a rental property?*

Yes

During the last 5 years have you had a judgement or lien?*

Yes

Have you ever had a policy non-renewed by an insurance carrier?*

Yes

Disclosure*

View the disclosure document.

Yes, I have read the disclosure

How did you meet Julie?*

Referral

Who referred you?*

Insured/Principal's Name*

Date of Birth*

MM slash DD slash YYYY

Insured/Principal's Home Address*

Street Address Address Line 2 City State ZIP Code

Please note that any policy changes, additions, deletions or endorsements are effective until confirmed in writing by the realprotect team.

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