test REI Name * Last * Name of individual(s), or entity that owns the property (LLC, corporation, name(s), etc) * Email * Phone Number Date of Birth * Mailing Address * Mailing Address Mailing Address Mailing Address Mailing Address Mailing Address Mailing Address Property Address That Needs Insurance * Property Address That Needs Insurance Property Address That Needs Insurance Property Address That Needs Insurance Property Address That Needs Insurance Property Address That Needs Insurance Property Address That Needs Insurance The status of the property is (or will be)... * SelectFully RentedVacantVacant and Under ConstructionPartially VacantOther (Elaborate in Comments) Purchase Price (If known) If the property is not already owned, what is the anticipated closing date? How many units is the property? If you're doing renovations to the building please elaborate on what you're doing If you're doing renovations, what are the costs? Approximate Age of Roof Approximate Age of Plumbing Approximate Age of Electrical System Approximate Age of HVAC system Is the electricial on circuit breakers? * SelectYesNoUnsure Monthly Rental Income (if applicable) Do you use a property manager? * SelectYesNoUnsure Any Section VllI /Subsidized housing? * SelectYesNoUnsure Is there any damage to the property? * SelectYesNoUnsure If property already owned, any claims/losses in past 3 years? * SelectYesNoUnsure What is your intention with this property? * SelectRent Buy and Hold PropertyFlip (Sell for Profit)Unsure What property deductible would you like? * Select$1,000$2,500$5,000$10,000$25,000Unsure If you're borrowing money to buy this property please provide us with the leader / loss payee / mortgagee clause (if known) How did you hear about us? Comments / Notes Upload Documents - If property already owned, please upload your current policy or declaration page Drop a file here or click to upload Choose File Maximum file size: 268.44MB Please upload current insurance policies or declaration pages, if you currently have insurance on this property. By providing a telephone number and submitting the form you are consenting to be contacted by SMS text message. Message & data rates may apply. Reply STOP to opt out of further messaging. Captcha If you are human, leave this field blank. SUBMIT
