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Company Information
Condos
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Condos Insurance Questionnaire
Closing Date
Date
Real Estate Company
Contact Person
First Name
Last Name
Phone Number
Fax Number
Personal Info
Date of Birth
First Name
Last Name
Marital Status
Married
Single
Occupation
Spouses Name
Spouses Date of Birth
Spouses Occupation
Phone Number
Email Address
Date of Birth
Address
Property Address: (If different)
Address
Purchase Price
Occupancy
Primary
Secondary
Sessional
Rental
Type
HO6
Type
Owner Occupied
Tenant
Flood Zone
Yes
No
New Purchase Or Previous Insurance Co
Year Built
Security System
Yes
No
Fireplace
Yes
No
Number of Floors in Building
Floor unit is on
Number of Condos in Complex
Construction
Number of Buildings in Complex
Roof Type
How Old
Circuit Breakers or Fuse Box:
Circuit Breakers
Fuse Box
If 30 years old, the year electrical was updated
Square Footage
Animals
Yes
No
Type
Swimming Pool
Spa
Hot Tub
Fenced
Screened
Slide
Diving Board
Pool Type
Above Ground
Inground
Distance to Gulf (miles)
Amount of Insurance
Dwelling (Additions and Alterations)
Contents (Personal Property)
Personal Liability
Trampolines
Yes
No
Bankruptcy
Yes
No
Losses in 3 years (on any property)
Title Company/Contact Person
Phone
Mortgage Company/Contact Person
Phone
Submit
