Insurance Election Agreement
Please complete this form to select an insurance policy to cover your belongings while they are in storage.
Please select the policy that is right for you.
Limit of coverage: $2000 - Monthly premium: $9
Limit of Coverage: $3000 - Monthly Premium: $13
Limit of Coverage: $5000 - Monthly Premium: $22
Limit of Coverage: $7500 - Monthly Premium: $32
My belongings exceed the coverage limits listed; I will need a custom policy.
First Name & Last Name
Address + City + State + Zip
I understand that the policy I have chosen will be automatically included in my amount due monthly.
My name below serves as my signature indicating my election of the insurance coverage selected above.
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