Insurance Landlord Quote

INSURANCE LANDLORD QUOTE

Quote Reference

Quote Number:

Quote Date:

Applicant / Insured Information

Date of Birth:

Property to be Insured

Number of Units:   Year Built:   Construction Type:

Occupancy Type:   Security Features:

Policy Details & Coverage Options

Select desired coverages and specify limits. Coverage is subject to underwriting approval and policy terms and conditions.

Dwelling Fire    Residential Landlord    Commercial Rental    Vacant Property

Policy Period Start:   End:

Optional Endorsements & Additional Coverages

Umbrella Liability    Earthquake (where available)    Flood (where available)    Legal Expense Coverage

Estimated Premium & Payment

Payment Frequency:   Estimated Installment:

Documentation Checklist

Attach or confirm availability of the following supporting documents:

Loss history / prior five years' loss runs    Photographs of property exterior    Current lease agreements    Prior policy declarations page

Mortgagee / Loss Payee / Beneficiary

If applicable, list any mortgagee, loss payee or additional insured to be named on the policy.

Exclusions, Conditions & Representations

This quote sets forth proposed coverage and estimated premium based on representations made by the applicant. Coverage will be issued only upon acceptance by the insurer and upon completion of underwriting, payment of premium, and execution of the policy. Standard policy exclusions will apply, including but not limited to:

• Loss or damage caused by intentional acts or willful misconduct of the insured;
• Loss or damage resulting from wear and tear, gradual deterioration, maintenance deficiencies, or hidden/latent defects;
• Loss arising from ordinance or law unless specifically endorsed;
• Pollution, mold and contamination losses except where specifically endorsed;
• Flood and earthquake perils unless specifically included by endorsement.

By signing below the applicant certifies: the information provided in this quote request is true and complete to the best of the applicant's knowledge; the applicant authorizes the insurer and its representatives to inspect the property and obtain relevant underwriting information; the applicant understands that this quote is not binding and coverage will only be effective upon issuance of a policy and payment of required premium.

Acknowledgement

I acknowledge receipt of this quote and understand that this document is a proposal, not a policy. The insurer relies on the representations contained herein. Misrepresentation or omission of material facts may void coverage or affect claims.

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