Condo/Townhomes/Single Family Homes Quote

Community Association Insurance
Please check all that apply Optional	C.C. & R's (Insurance Section) Reserves and Current Financials or Budget Plot Map FEIN Renewal Current Insurance Dec. Pages or Annual Disclosures
If Renewing, please provide Expiration Date Optional
General Information
Property Name Required Property Name is required.
First Name Required Input Required
Last Name Required Input Required
Physical Location # and Street Required Physical Location # and Street is required.
City Required Input Required
State Required Input Required	select AZ CA CO
ZIP / Postal Code Required Input Required Please enter a valid Postal code.
Primary Phone Number Required Input Required Please enter a valid phone number
E-Mail Address Required You must provide an e-mail address. A valid e-mail address is required.
Management Company Optional
Year Built Optional	select 2013 2012 2011 2010 2009 2008 2007 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982 1981 1980 1979 1978 1977 1976 1975 1974 1973 1972 1971 1970 1969 1968 1967 1966 1965 1964 1963 1962 1961 1960 1959 1958 1957 1956 1955 1954 1953 1952 1951 1950 1949 1948 1947 1946 1945 1944 1943 1942 1941 1940 1939 1938 1937 1936 1935 1934 1933 1932 1931 1930 1929 1928 1927 1926 1925 1924 1923 1922 1921 1920 1919 1918 1917 1916 1915 1914 1913 1912 1911 1910 1909 1908 1907 1906 1905 1904 1903 1902 1901 1900
Single Family Homes or Condos Optional
Property Information
# of Units Required # of Units is required.
# of Buildings Required # of Buildings is required.
# of Stories Required # of Stories is required.
Approximate Square Footage Required Approximate Square Footage is required.
Construction Type Required Construction Type is required.
Club House Square Footage Optional
Fire Sprinklers in Building Required Fire Sprinklers in Building is required.	Yes No
Smoke Detectors in Units Required Smoke Detectors in Units is required.	Yes No
Fire Extinguishers Required Fire Extinguishers is required.	Yes No
Playground Equipment Required Playground Equipment is required.	Yes No
Swimming Pools? Required Swimming Pools? is required.
Exercise Equipment Required Exercise Equipment is required.
Property Coverages
Building Limit Required Building Limit is required.
Contents Limit Required Contents Limit is required.
Business Income Limit Required Business Income Limit is required.
Property Deductible Required Property Deductible is required.
Bare walls or Complete Unit Interior Coverage Required Bare walls or Complete Unit Interior Coverage is required.
Earthquake Coverage? Required Earthquake Coverage? is required.	Yes No
Flood Insurance Coverage? Required Flood Insurance Coverage? is required.	Yes No
Liability Coverages
General Liability Limit Required General Liability Limit is required.
Directors & Officers Liability Limit Required Directors & Officers Liability Limit is required.
Fidelity / Crime Limit Required Fidelity / Crime Limit is required.
Umbrella Liability Limit Required Umbrella Liability Limit is required.
Automobile Liability Limit Required Automobile Liability Limit is required.
Any Owned Autos? (If yes, please provide Year, Make, Model, & VIN below) Required Any Owned Autos? (if yes, please provide Year, Make, Model, & VIN below) is required.	Yes No
Year, Make, Model, & VIN Optional
Enter Validation Code Required

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