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Check box if you need to correct the address:
How did you obtain the corrected address?
Address:
Were you able to verify all the rating basis the customer requested?
What rating basis were you unable to obtain?
Was an interview conducted?
Person interviewed (must be first and last name):
Position and/or title:
What was the other title?
What date was the interview conducted?
Was the agent contacted for assistance?
How many attempts were made to contact the insured and/or the agent?
What type of business is on the property?
Select all supplement forms that apply to this business:
Select all supplement forms that apply to this type of business:
Is the insured the building/property owner or tenant?
Number of owners?
Approximately what percentage does the building owner occupy?
Does the owner have a tenant or tenants in the building?
Does the owner require the tenant to provide proof of insurance naming the owner as an additional insured on their policy?
What is the tenant square footage?
Is the property vacant or partially vacant?
What percentage of the building(s) is vacant?
What are the insured's plans for the vacant property?
Description of business operations:
What type of business ownership?
Insured's years of experience at this type of business?
How long has insured been at this location?
Does insured have other locations?
How many other locations (including this location)?
What type of neighborhood?
Has there been any losses in the last 5 years?
Describe in detail the loss (This must be more than just an answer of "Hail"):
Date of last loss:
How many days a week are they open?
Average opening time?
Average closing time?
Does the owner have any contents in the building?
Describe the building owner's contents:
What is the content value? (In dollars):
Does the tenant have any contents in the building?
Describe the building tenant's contents:
What is the tenant content value? (In dollars):
Additional Notes:
Type of operation
Did you attach a list of equipment with make, model, and s/n?
Where is the equipment stored at night?
What type of protection do they have?
Describe the other type of protection:
Are keys removed from all equipment when not in use?
Where are the keys kept?
Does the equipment have electronic GPS tracking devices?
List all equipment that has a GPS tracker on it:
How is the equipment transported to a jobsite?
Is equipment leased to others?
Does the insured supply the operator for the equipment leased?
Do company name and ID# appear on the equipment?
Are all serial numbers recorded and kept on file?
Who maintains the equipment?
Do they have a maintenance agreement?
Are appropriate fire extinguishers in place?
Are the fire extinguishers maintained annually by a professional firm?
What type of cargo/materials are being transported?
Are there any hazardous or flammables being transported?
How is the cargo being transported by?
Describe other type of transportation:
Approximate distance to destination? (in miles):
Approximate value of shipment? (in dollars):
Are identifying data or serial numbers kept?
Does cargo have permanent identification numbers?
Submitted
Edit
Incorrect
asas
asa, sas, as,
Yes
Yes
asasas
Owner
asasasas
Thursday, November 30, 2006
Aircraft hangar
Building owner only
11
Yes
No
asasa
No
asasas
Corporation
1 year
1 year
Yes
11
Rural
No
asasa
Sunday, November 10, 1996
3 days
2 am
12 noon
Yes
asasa
asas
No
asas
asasa
sasasas
Contractor equipment
Yes
Depends on jobsite location
Fencing
asasas
Yes
asas
No
asasas
Truck and trailer
Yes
Yes
No
No
asasa
Yes
No
No
aasasas
No
Insured vehicles
sdsds
asasas
asas
No
No
2 months ago