Personal - Homeowners Application - Frankel & Associates

Property Information

Is the property address the same as the mailing address above?*

Yes
No

Please provide the address for the property to be insured.*

Street Address City State ZIP Code

What type of residence is it?*

Single Family Dwelling
Duplex
Triplex

Is the property occupied?*

Yes
No
Not currently but will be within 30 days

Who is living in the Residence?*

Renting to a tenant
Insured living in residence

Are there multiple buildings on the property's lot?*

Yes
No

I.E.: additional, detached dwellings, detached garages, storage sheds/buildings, etc.

What type of Additional Buildings are there?*

Dwelling
Detached Garage
Storage Shed/Building

How many additional buildings are there?*

1
2
3

Is there a Property Management Company you've hired or will hire to oversee the property?*

Yes
No

What is the name of the Property Management Company?*

What is the name of your contact at the Property Management Company?*

What is the Property Management Company's Phone Number?*

What is the Property Management Company's Address?*

Street Address City State ZIP Code

Date of property purchase or projected closing date*

What year was this property built?*

Please enter a number greater than or equal to 1800.

Number of stories*

Number of bedrooms*

Number of bathrooms*

Foundation type*

Concrete
Basement
Crawl space

Construction Type*

Roof Type*

Is the roof flat?*

Yes
No

What is the main source of heating?*

Are there any fireplaces?*

Yes
No

How many fireplaces?*

Are your fireplaces masonry or fabricated?*

Masonary
Fabricated
Both

Is there an auxillary heating source?*

Yes
No

What type of auxiliary heating do you have?*

Please provide a description of your auxillary heating source.

Date of heating upgrade*

Please provide a date or estimate of the last heating upgrade.

Date of plumbing upgrade*

Please provide a date or estimate of the last plumbing upgrade.

Date of roofing upgrade*

Please provide a date or estimate of the last roofing upgrade.

Date of electrical upgrade*

Please provide a date or estimate of the last electrical upgrade.

Date of wiring upgrade*

Please provide a date or estimate of the last wiring upgrade.

Is there any planned construction in the next six months?*

Yes
No

Please provide details*

Has the building been earthquake retrofitted?*

Yes
No

Is the property within city limits?*

Yes
No

Is this area considered to be in "brush" territory?*

Yes
No

Is the property visible to neighbors?*

Yes
No

Does the property have a central-station activated:*

Fire Alarm
Burglar Alarm
Both
None of the Above

If you have a copy of the alarm certificate you can upload, please do so here:

Max. file size: 50 MB.

Do the windows have bars?*

Yes
No

Do the window bars have quick-release levers?*

Yes
No
Unknown

Does the property have Carbon Monoxide Detectors Installed?*

Yes
No

Does the property have working smoke detectors installed?*

Yes
No

Are the smoke detectors:*

Battery Operated
Hard-Wired
Hard-Wired w/Battery Backup

Does the Property have a Sprinkler System installed?*

Yes
No

By "Sprinkler System" we mean one that protects the inside of the building from fire - not a sprinkler system for the yard.

Does the property have a pool?*

Yes
No

Is the pool properly fenced to city code?*

Yes
No

Does the property have a hot tub?*

Yes
No

Is the hot tub properly fenced to city code?*

Yes
No

Does the occupant have any pets?*

Yes
No

Any Dogs, Non-domestic cats, dangerous reptiles, small farm animals, Wild Animals, Large Domestic Hoofed Animals, Snakes, Etc.

Please list all pet types and breeds.*

Is there a garage, carport, or detached carport?*

Yes
No
Both

How many vehicles does it hold?*

1
2
3

Will you need coverage for any personal property at the location?*

Yes
No

Such as furniture, appliances, or other items that are not considered to be part of the structure of the building. Valuable items like fine art and jewelry will need to be covered separately.

What is the value of the personal property located within this residence?*

Is there or will there be a lender/mortgage in place?*

Yes
No
Yes, but it's not known who the lender will be at this point

Please provide the Lender's Name, Address and the Loan Number/s so we can add them as Mortgagee and Loss Payee to the Policy:*

If you can supply a copy of recent evidence of insurance that was sent to your lender, we will accept that in lieu of your providing the information here.

If you have a copy of recent evidence of insurance that was sent to your lender, please upload it here:

Max. file size: 50 MB.

Please Choose the Policy Payment Option that Best Suits your Needs:*

Pay in Full
Payment Plan
Lender/Escrow Paid

Please only choose "lender/escrow paid" if you know for certain that your lender or the escrow company will be making payment for your policy.

Personal - Homeowners Application

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Personal - Homeowners Application

Customer Information

Property Information