Renewal Marketing Application

Renewal Application

Please Complete the Form Below:

Step 1 of 7

14%

Applicant Information

Requested Effective Date(Required)

MM slash DD slash YYYY

Legal Owner Name(Required)

Type of Organization(Required)

Individual

Corporation

LLC

Other

Address(Required)

Street Address Address Line 2 City State ZIP Code

Is Your Billing Address Different(Required)

Yes

Billing Address (if different)(Required)

Street Address Address Line 2 City State ZIP Code

Company Phone(Required)

Company Website

Contact Name(Required)

First Last

Contact Email(Required)

Contact Phone(Required)

Contact Fax

Requested Base Deductible(Required)

$2,500

$5,000

$10,000

$25,000

Separate Wind Deductible (If available)

$5,000

$10,000

$20,000

Portfolio Information

States Where Properties Are Owned(Required)

Total Number of Properties Owned(Required)

Additional Entities / Named Insureds / Additional Insureds

Current Insurance Carrier(s)(Required)

Do You Fix of Flip Homes?(Required)

Yes

Percentage of Portfolio that is Rented vs. Flipped?

How is Insured Value Calculated(Required)

(i.e. per sq. ft., purchase price, cost basis)

Do you arrange inspection of properties prior to and/or after foreclosure or acquisition?(Required)

Yes

N/A

If Yes, Please Provide Details(Required)

Have any investment properties you own, control or manage experienced a property or liability insurance loss in the last 3 years?(Required)

Yes

If Yes, Please Provide Details(Required)

Please complete the Statement of No Known Losses at the end of this form.

Average Time a Property Asset is Held(Required)

Have you ever had similar insurance declined, cancelled or non-renewed?(Required)

Yes

If Yes, Please Provide Details(Required)

(Except Missouri)

Have you had a past conviction for arson, fraud, or other insurance-related offense?(Required)

Yes

Have You Filled Bankruptcy in the Past 5 Years?(Required)

Yes

Vacant Property

Do you have written procedures for the regular inspection of vacant properties?(Required)

Yes

How often are vacant property(ies) visited by the applicant, agent, or property management company?(Required)

Property Secured Against Entry(Required)

Yes

Previous Owner/Tenant Access Blocked?(Required)

Yes

All Utilities Disconnected as Needed?(Required)

Yes

Property Protected Against Freeze?(Required)

Yes

On average, how long is a property vacant between tenants?(Required)

What is the maximum amount of time any dwelling has been vacant?(Required)

Property Management

Is a Property Management Firm Utilized?(Required)

Yes

Name of the Company(Required)

Do you have a signed contract with the property management company detailing what is expected?(Required)

Yes

Do you have risk management procedures / practice / formal maintenance program?(Required)

Yes

If Yes, Please Describe(Required)

Is there a signed rental agreement with all tenants?(Required)

Yes

Do you conduct a background check on all prospective tenants/occupants over the age of 18?(Required)

Yes

Are tenants required to carry a renter's insurance policy?(Required)

Yes

Have any properties had more than 3 tenants in the pas year?(Required)

Yes

Do you abide by all state tenant/landlord laws?(Required)

Yes

Do you have written eviction procedures that comply with all applicable laws/(Required)

Yes

What is the typical response time when emergency repairs are needed?(Required)

General Information

Are any properties for sale?(Required)

Yes

Do you have any student tenants?(Required)

Yes

If yes, does student housing exceed 20% of the total scheduled values?(Required)

Yes

Do you have subsidized renters?(Required)

Yes

If yes, please indicate building address(es)(Required)

Is any property rented on a short term (less than 12 months), seasonal, or weekly basis?(Required)

Including VRBO, Airbnb, or similar type of rentals.

Yes

Are all doors/sliding glass doors equipped with proper locks and dead locks?(Required)

Yes

Does each dwelling have smoke detectors and/or fire extinguishers?(Required)

Yes

Is there a procedure in place to replace smoke detector batteries?(Required)

Yes

Does each dwelling have a minimum of two means of egress?(Required)

Yes

Do any buildings have decks or balconies?(Required)

Yes

If yes, are they properly constructed with maximum 4" openings/pickets?(Required)

Yes

Do any properties have a swimming pool or in-ground spa?(Required)

Yes

If yes, are they properly fenced and secured with a self-latching gate?(Required)

Yes

Renovation & Contracting Information

Are any buildings undergoing renovations or reconstruction?(Required)

Yes

Please describe your typical renovation

Cosmetic?(Required)

Yes

If yes, provide address(es)(Required)

Structural?(Required)

Yes

N/A

If yes, provide address(es)(Required)

Do you use independent contractors?(Required)

Yes

N/A

If yes, do you obtain a certificate of insurance?(Required)

Yes

N/A

How long is the typical renovation period?(Required)

Prior to renovations, are all necessary local permits pulled?(Required)

Yes

N/A

Applicant Warranty

THE APPLICANT (ASSURED) AGREES TO MAINTAIN ACCURATE BOOKS AND RECORDS AND REPORTS FOR THE PURPOSE OF ESTABLISHING THE EFFECTIVE DATE OF COVERAGE FOR ANY PROPERTY TO BE COVERED UNDER THE POLICY APPLIED FOR AND TO PERMIT ACCESS TO SUCH RECORDS BY ANY REPRESENTATIVE OF THE UNDERWRITERS AFFORDING COVERAGE. FURTHER, APPLICANT WARRANTS THAT ALL THE INFORMATION ON THIS APPLICATION IS TRUE, CORRECT, AND COMPLETE; AND APPLICANT UNDERSTANDS THAT IT IS THEIR RESPONSIBILITY TO READ AND COMPREHEND THE CONTENTS OF THIS APPLICATION, AND THAT ANY MATERIAL MISREPRESENTATION OR OMISSION WILL INVALIDATE COVERAGE. NOTE: THIS IS NOT A POLICY OF INSURANCE, THIS APPLICATION FORM IMPARTS NO COVERAGE WHATSOEVER. COVERAGE CAN NOT BE BOUND WITHOUT UNDERWRITER'S RECEIPT AND ACCEPTANCE OF THIS APPLICATION. THIS APPLICATION ATTACHES TO AND FORMS A PART OF ANY SUBCERTIFICATE OR CERTIFICATE OF INSURANCE AT THE TIME OF ISSUANCE.

Signature(Required)

By filling out this field you are agreeing to the disclosure document.

Date(Required)

MM slash DD slash YYYY

Printed Name(Required)

Date of Birth(Required)

MM slash DD slash YYYY

Insured/Principal's Home Address(Required)

Street Address Address Line 2 City State ZIP Code

CAPTCHA

Date

MM slash DD slash YYYY

Please complete this form only if one of the following are true:

Select one option

This letter is to certify that I am not aware of any losses, accidents or circumstances for any properties that we own, control or manage that might give rise to a claim on previous policy(ies) for a period of three years prior to the date of this letter.

This letter is to certify that the locations that are part of this portfolio are new purchases and I/we have no knowledge of any of any losses, accidents or circumstances that might give rise to a claim.

Signature(Required)

By filling out this field you are agreeing to the disclosure document.

Date

MM slash DD slash YYYY

Printed Name

Title

Name

This field is for validation purposes and should be left unchanged.