Community Association Insurance Quote Form
Name of Insured Association or Business:
Coverage for all Buildings
Covers Common Areas Only
Have we provided a quote for your association in prior years?
Number of Buildings:
Number of Units:
50% or more rental units?
Number of Stories:
Year Built (or approximate):
Total Square Footage:
Total Property Value:
Rental Income (if any):
Year Buildings were last re-roofed:
Hard Wired with Central Station Monitoring
Battery in Units; Hard Wired in Common Areas
Is there a sprinkler system in the building(s)?
Please describe the extent of sprinkler coverage:
Any swimming pools?
Association own any Autos?
Check all that apply.
Pool is fenced in.
Fence has a self closing & latching gate.
Pool has a Slide, Diving Board or Jump Board.
Lifeguards - Independent Contractor
Lifeguards - Employees
Pool is rented out for private parties.
Public membership is permitted.
Renewal Date of Current Policy:
Any Claims in the Past 3 Years?
Please attach a current loss run for the Association below or provide information on the claim detail, including the date of the claim(s), amount paid and a brief description of the loss.
If you are requesting a quote for a condominium or community association, our underwriters will need the following information in order to provide a firm quotation.
If you have any of these items available, please check the box next to the item to upload and send the information with this quote request.
A current copy of the Association's claim history (a loss run)
A complete set of the Association's Declarations and By-laws
A current Association budget
A site plan for the community
Copy of Current Policy for coverage review
1) A current copy of the Association's claim history (a loss run)
2) A complete set of the Association's Declarations and By-laws
3) A current Association budget
4) A site plan of the community
5) Copy of Current Policy to review coverages and limits.
Property Management Company: