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Builders Risk and Vacant property Quote Form
If a questions is not applicable, put NA in the required field in order to bypass.
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Contact Information
What Name Should Insurance Be Under?
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If you want the policy listed in a company name, enter the name here.
Contact Name
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First
Last
Phone Number
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Email Address
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Company Type
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Individual
Corporation
LLC
Other
How did you find us?
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Choose One
Existing Client
Referral
Web Search
If other company type, explain
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Mailing Address
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Line 1
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City
State
Zip Code
Country
How many months of coverage needed
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Select one
1 month
2 months
3 months
4 months
5 months
6 months
7 months
8 months
9 months
10 months
11 months
12 months
Year Built
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If new ground up enter current year, otherwise enter year the existing structure was built.
Start Date
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Provide the project start date here
# Stories
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Expected Completion Date
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Existing Square Footage
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Construction Type
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Frame
Brick Veneer
Joisted Masonry
Metal
Non-Combustible
Frame - exterior walls constructed of wood or other combustible materials such as brick veneer, stone veneer, wood and stucco on wood. Joisted Masonry - exterior walls constructed of masonry materials such as brick, concrete, block, stone or similar materials and the floors and roof are of wood construction. Non-Combustible - exterior walls, floors and roof constructed of metal, gypsum or other non-combustible materials.
If Renovation describe work being done, be specific?
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If not applicable, enter NA
If for loan, what is your closing date?
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If not applicable, enter NA
Lenders mortgagee clause & address?
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If not applicable, enter NA
Location Address (property to insure)
Location Address
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Line 1
Line 2
City
State
Zip Code
Country
County
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If Remodeling, do you want coverage for existing structure?
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Yes
No
Choose all that apply
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Property within 1,000 feet of tidal water
Property is on a barrier island
Property is Modular
Property in wind pool area
Chose one that applies
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I'm the Owner
I'm the Contractor
I'm Both the Owner & Contractor
Builders Name
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If Builder is different than the owner, list builders name here.
Choose all that apply
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Builder has 2+ Year Experience
Builder has not had a single loss greater than $10,000 in 3 years
Builder has built > 3 homes last year
Builder is building >3 homes this year
Choose all that apply
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New Ground Up Construction
Remodeling - Non Struructural
Remodel - Minor Structural
Remodel - Major Structural
Remodel - Remodeling of interior finishes; exterior painting; replacement of interior fixtures, cabinets, flooring, etc. No structural changes. Remodel/Minor Structural - Remodel work as listed above and minor changes to exterior (doors, windows, skylights, etc.). Roof replacement, ground floor additions and all non-structural changes such as HVAC, plumbing and electrical. Restructuring - Repair, replace, remove load bearing walls. Adding additional stories, adding stairways or elevators. Foundation work such as underpinning and/or dewatering.
Type Project
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Residential Property
Commercial Property
Amount of Rennovation
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List the total dollar amount of the rennovations to be done.
Value of Existing Structure
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Insert the value of the existing structure, if you want coverage for existing structure.
Choose All work being done which applies.
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Replacing Load Bearing Walls
Adding Horizontal Addition
Adding Vertical Addition
Under Pinning Work
If adding square footage, please list the amount being added?
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Choose All that apply
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Current Roof < 15 Years Old
Current Electrical < 15 Years Old
Plumbing < 15 Years Old
HVAC < 15 Years Old
New Roof being added as part of renovation
Plumbing being updated as part of renovation
Electrical being updated as part of renovation
HVAC being updated as part of renovation
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