Submit Hotels & Habitational Risk

Agent Information

Agent Name

Agency Name

Email

Phone

Insured Information

Insured Name

DBA (if applicable)

Contact Name

Contact Email

Contact Phone

Business Website

Years in Business

FEIN/Tax ID

Mailing Address

City

State

ZIP Code

Property Information

Property Address

Property Type

Year Built

Square Footage

Number of Stories

Number of Units/Rooms

Construction Type

Sprinklered

Alarm System

Roof Type

Year Roof Replaced

Plumbing Type

Year Plumbing Updated

Electrical Type

Year Electrical Updated

Heating Type

Year Heating Updated

Occupancy Rate (%)

Amenities Information

Swimming Pool

Hot Tub/Spa

Fitness Center

Restaurant on Premises

Bar/Lounge on Premises

Security Features

Coverage Information

Requested Effective Date

Expiration Date

Building Value ($)

Contents Value ($)

Business Income ($)

Liability Limit ($)

Document Upload

Upload Loss Runs

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Upload ACORD Forms

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Upload Property Photos

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