Basic Tools
Heading
Text Box
Text Area
Drop Down
Radio Button
Check Box
Advanced Tools
Full Name
Email
Address
Phone
Date Picker
Home
Save
Preview
Embed
Unpublish
Light
Dark
Package Test Copy
General Information
Did you get interior photos? (All buildings must have interior photos unless it's residential with no access)
*
Yes
No
Residential with no access
This client requires interior photos
Need to correct address?
*
Yes
No correction needed
How was the corrected address obtained?
*
Insured
Agent
Internet search
Office assistance
Other
Other:
*
Address:
*
Street address
Street address 2
City
State / Province
zip code
Were you able to obtain all the rating basis and special notes?
*
Yes
No
Change report type to "Unable to complete". Save your photos for future use.
Person interviewed?
*
Yes
No
Person interviewed (First and Last name):
*
Position and/or title:
*
Owner
Bookkeeper
Manager
Assistant Manager
Tenant
Other
You are not to interview the agent for information in the report.
Other title:
*
Date of interview (Needs visibility rule for contained values):
*
January
February
March
April
May
June
July
August
September
October
November
December
Month
01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Day
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
Year
Occupancy
Select what best fits the property:
*
Adult daycare
Aircraft hangar
Airport terminal
Apartment 4+ units (Client ordered each building value)
Apartment 4+ units (Total all buildings together)
Auditorium
Auto mini lube
Auto Sales/Showroom
Auto salvage
Auto service center
Bank
Bar/Tavern
Beauty salon/Barber shop
Bed and breakfast
Bowling alley
Bus terminal
Cannabis store/Warehouse
Car wash
Caterer
Church
Cold storage facility
Community center
Convenience store
Country club
Daycare center
Department store
Discount store
Duplex/Triplex 2-3 units
Fast food restaurant
Fitness center
Funeral home
Heavy manufacturing
HOA/POA (Home/Property owner association)
Hotel/Motel
House converted to office
Laundromat/Dry cleaning
Light manufacturing
Medical office
Mini storage warehouse
Mobile home park
Movie theater
Multi-occupancy business
Nursing home/Retirement home
Office
Open pavilion
Other (Explain in business description)
Parking garage
Post office
Prison
Private club
Rental/Meeting hall
Restaurant
Restroom building
Retail store
Retreat center
School
Self-storage warehouse
Shopping center strip
Single family dwelling
Social club
Strip center
Supermarket/Grocery
Surgical center
Townhome/Condominium HOA
Townhome/Condo (1 unit)
Townhomes/Condo complex
Vacant building
Vacant dwelling
Vacant land or vacant parking lot
Warehouse
Property description: The risk is a single family dwelling.
Do not use "Other" unless you have a very unusual type of business. If the reviewers can change it they will and it will be returned.
Types of building(s) on property:
*
Common buildings on property
Mobile homes owned by the insured
Single family dwelling
No buildings
Swimming pool
*
Yes
None
Select all that apply1:
*
None
Apartment
Convenience store
Daycare
Hotel/Motel
Laundromat/Dry cleaners
Nightclub
Playground
Restaurant
Select all that apply:
*
None
Cooking
Daycare
Playground
Select all that apply:
*
None
Cooking
Select all that apply:
*
None
Cooking
Bar/Nightclub
Active fields on your form can be edited in the box below.
Form Properties
Title
Theme
Black
Dark Red
Notification Email
Confirmation Msg
Thank you for signing up
Field Properties -
Text
Label
Max Characters
Required
False
True
Hide Control
No
Yes
Control Action
--Please Select--
Show
Hide
Options
Selected Option
Hint
Property Lens
Minimum Age
100
99
98
97
96
95
94
93
92
91
90
89
88
87
86
85
84
83
82
81
80
79
78
77
76
75
74
73
72
71
70
69
68
67
66
65
64
63
62
61
60
59
58
57
56
55
54
53
52
51
50
49
48
47
46
45
44
43
42
41
40
39
38
37
36
35
34
33
32
31
30
29
28
27
26
25
24
23
22
21
20
19
18
17
16
15
14
13
12
11
10
9
8
7
6
5
4
3
2
1
Maximum Age
100
99
98
97
96
95
94
93
92
91
90
89
88
87
86
85
84
83
82
81
80
79
78
77
76
75
74
73
72
71
70
69
68
67
66
65
64
63
62
61
60
59
58
57
56
55
54
53
52
51
50
49
48
47
46
45
44
43
42
41
40
39
38
37
36
35
34
33
32
31
30
29
28
27
26
25
24
23
22
21
20
19
18
17
16
15
14
13
12
11
10
9
8
7
6
5
4
3
2
1
Valid Extensions
Max. File size (kb)
Min. File size (kb)
Help Text
Recommendations
Advance Setting
Auto-saving
Copy Embed Script
x
Close
(or press ESC or click the overlay)
×
Auto-saving