Apartment Quote Form
Insured Name (required)
E-mail (required)
Management How many buildings: Total square footage all buildings: Amount of building insurance:         Owner Manages Owner Lives on Premises Insured Employee Lives on Premises   # of full/part time employees Management Firm Manages     Name of Management Firm Address of Management Firm City of Management Firm State and Zip of Management Firm
Number of tenants the insured has evicted in past 3 years
Does the insured plan to evict anyone in the upcoming 30 days?	Yes No
Law firm used for evictions?
Name of Law firm
Address of Law Firm
City
State and Zip of Law Firm
Please provide details including dates and awards of any lawsuits flied against the owner within the past 5 years by a tenant or guest.
Are you aware of any potential law suits being filed?	Yes No
Average Rent Per Unit
Number of Vacant Units
Percent of Units Subsidized
Any Major Renovation Plans?	Yes No
Location Information
If there is more than 1 building at the location, please fax a diagram to 415-664-4159
Have you personally inspected the location?	Yes No
How many fire extinguishers are there in the building?
Type and size of extinguishers
How often are the extinguishers tested and recharged?
Are records kept of service dates?	Yes No
Smoke detectors per unit	Hard Wired Battery Operated
How often does the insured test the alarms?
Where are the testing records kept?
What sort of sprinkler system does the location have?	Full No
How many elevators are there?
Elevator maintenance contact?	Yes No
Do any windows have security bars?	Yes No
If yes, are ALL equipped with quick release latches?	Yes No
On any above ground floor railings, what is the maximum distance between railings?
Is the location on a hill or slope?
How steep? (degrees)
If a condominium, what percent of units are owner occupied?
What are their annual dues?
Is this designated senior housing?	Yes No
If so, what is the average age of the tenants?
Please provide, if applicable, what percent is student housing.
Recreation Facilities
Number of pools and jacuzzis
Are they separately fenced?	Yes No
Fence type and height
Does each fence have a self-locking gate?	Yes No
Are there any lakes, ponds, or fountains?
Please describe any protective barriers on these.
Describe any outdoor sports facilities
Describe any exercise/tanning/sauna or gym equipment available for tenant use?
Is there a service/maintenance schedule for the pool, exercise/sauna and/or gym equipment?	Yes No
Is there a playground?	Yes No
Age of playground equipment?
Please answer each question for each building 25 years and older. Owners must provide specific documentation or a report from a contractor or equivalent professional verifying the age and condition of the electrical, plumbing and heating systems, and of the roof.
Electrical
100% Circuit Breakers 100% fuses With Fuse Stats With Ground Fault Interrupts 100% Copper romex or conduit wiring Aluminum Other (describe)
When was the electrical system last upgraded?
Did a licensed contractor do the work?	Yes No
Full Upgrade Partial Upgrade (describe)
When, if ever, was it last inspected by a licensed contractor?
Plumbing
What type of pipes does the building have?	Copper Galvanized Other (describe)
When were the pipes last replaced?
Full Upgrade Partial Upgrade (describe)
When were the laundry room hoses last replaced?
When were bathroom and kitchen fixtures last updated?
Any water heaters double strapped in compliance with earthquake codes?
Heating
The primary heat source is Central Heating Wall Heaters Floor Heaters   Other
The fuel used is	Gas Electric Other
What is the age of the furnace/boiler/heaters?
Are they on a service contract?	Yes No
If no, when were they last inspected?
What supplemental heat source(s) are there? Wood Stove Coal Stove Portable Electric Portable Kerosene Other
Roofing
Age of roof
Condition
Type Asphalt Shingle Wood Shingle Tar and Gravel Tile Other

I would like more information on the following: