MASTER Property & auto Insurance Form.xlsx

	A	C	E
1	Personal Information	Co-Applicant
2	Insured Legal Name	Insured Legal Name	TO EDIT THIS FORM, YOU WILL NEED TO MAKE A COPY
3	Marital Status	Marital Status
4	Date of Birth	Relation to Insured	CLICK 'FILE' THEN 'MAKE A COPY'
5	Gender	Date of Birth
6	Current Occupation (discount)	Gender
7	Phone Number	Current Occupation (discount)
8	Email Address	Phone Number
9	Full Address	Email Address
10	Previous Address (If less than 3 years)	Full Address
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12	Property Information	Discounts and Underwriting
13	Home Within City Limits?	Alarm System (Y/N)
14	Property Occupancy	Monitored by 3rd party company?
15	Property Type	Water Leak Detector?
16	Date of Purchase	Located in Gated Community?
17	Property Currently Insured?	24 Hr Security?
18	If lapsed: enter last date of coverage	Trampoline?
19	Current Insurance Carrier	Trampoline Fenced/Netted?
20	Policy Expiration Date	Pool (Y/N)
21	Year Built	Hot tub/Jacuzzi?
22	Number of Bedrooms	Fenced/Screened Pool?
23	Number of Bathrooms	Diving Board/Slide?
24	Flooring Type (type entry if needed)	Number of dogs on property?
25	Construction Type	What are the breeds?
26	Exterior Wall Type	History of Biting?
27	Roof Material	Explanation of Biting History
28	Roof Type (Hip/Gable)	Current Policy Coverages
29	Number of Stories	Coverage A - Dwelling
30	Square Footage (exclude Basement)	Coverage B - Private Structures
31	Foundation Type	Coverage C - Personal Property
32	Basement Square Feet	Coverage D - Loss of Use
33	Basement daylight or walkout?	Coverage E - Personal Liability
34	Wood Deck/Screened Enclosure	Coverage F - Medical Payments
35	Deck/Enclosure Size (sqft)	All Other Peril (AOP) Deductible
36	Garage Type	Wind/Hail Deductible
37	Garage Size	Updates	Extent of Updates (Complete/Partial)
38	Number of Fireplaces	Year ROOF was last replaced
39	Fireplace Type	Year PLUMBING was last updated
40	Heating Type	Year ELECTRIC was last Updated
41	Shutters Covering All Openings?	Year HEATING was last replaced
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43	Claims	Claims
44	Filed Property Claims in Last 5 Years? (Y/N)	Filed Property Claims in Last 5 Years? (Y/N)
45	Date of Loss	Date of Loss
46	Cause of Loss	Cause of Loss
47	Description of Loss	Description of Loss
48	Amount of Loss	Amount of Loss
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50	Loan & Financial	Occupancy & Tenancy
51	Mortgage?	Number of Residents (18+)
52	2nd Mortgage	Number of Residents (<18)
53	Loan Number	Property Manager (landlord policy)?
54	Escrowed Account? (Y/N)	Tenant Has Renter’s Insurance (landlord)?
55		Flood Zone (Y/N)
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58	Notes
59	Additional Notes/Comments
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