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FORBUSINESSINSURANCE.COM
2640 E. Garvey Ave South, #207 W. Covina, Ca 91791
Tel: 626-653-0708 Fax: 626-653-0707

Apartment / Condo Questionnaire

NAME OF THE ENTITY:
PROPERTY LOCATION ADDRESS: *
NATURE OF BUSINESS:CORPORATION    INDIVIDUAL    PARTNER    
YEAR IN BUSINESS:,PRIOR EXPERIENCE:
FEDERAL TAX ID NUMBER:
Contact Person: *
Phone: *
TOTAL BUILDING AREA? 
ANY UNDERGROUND PARKING OR BASEMENT? YES    NO    
HOW MANY UNITS: 
MONTHLY RENTAL INCOME? $
SMOKE DETECTOR IN EVERY ROOM? YES    NO    
IF "YES",ARE THEY RAN BY BATTERY OR BY HARD WIRE? BATTERY    HARD WIRE    
AGE OF BUILDING
TYPE OF BUILDING:
MASONRY    STUCCO     OR OTHER
HOW MANY FLOORS? 
ANY SWIMMING POOL? YES    NO    
ANY SPRINKLERS IN THE BUILDING? YES    NO    
REPLACEMENT VALUE OF THE BUILDING:$ 
ARE YOU REQUIRED BY THE LANDLORD TO PROVIDE INSURANCE?
IF YES, PLEASE PROVIDE US WITH THE NAME AND ADDRESS OF YOUR LANDLORD:
YOUR RIGHT NEIGHBOR IS A? 
LEFT? 
REAR? 
DO YOU HAVE ANY PRIOR INSURANCE? YES    NO    
IF YES,PLEASE ANSWER THE FOLLOWING:
PRIOR INSURANCE NAME: 
POLICY #: 
EXPIRATION DATE: 
EXP. PREMIUM:$ 
DID YOU HAVE ANY CLAIM OR LOST? YES    NO    
IF YES, PLEASE PROVIDE THE DETAIL:
DATE OF LOST: 
AMOUNT PAID$: 
REASON OF LOST: 
DETAIL DESCRIPTION OF YOUR BUSINESS OPERATION
MAILING ADDRESS:
 
        


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