Apartment Questionnaire
Complete this form for a free, no-obligation, insurance quote. Please complete as much as possible – the information will be kept confidential.
APPLICANT INFORMATION SECTION
Applicant Name:
Legal Name:
Contact Name:
Location Address: 
City, State, Zip:   
Years of Experience:
Entity Type:
Phone:      Fax:
Email Address:
Federal ID or SS#:
Current Carrier:
Expiration Date of current Policy:
BUILDING INFORMATION SECTION
Number of Buildings:
Total Building Area:
Year Built:
Number of 1 Bedroom Units:
1 Bedroom Monthly Rate:
Number of 2 Bedroom Units:
2 Bedroom Monthly Rate:
Number of 3+ Bedroom Units:
3+ Bedroom Monthly Rate:
Total Number of Units:
Average % Vacant:
Annual Rental Income:
Total Contents Limit:
Total Building Limit:
Do Building(s) have Sprinkler System?
Name of Responding Fire Department:
Carports/Garages to Value:
Number of Carports/Garages:
Carports/Garages Construction Type:
Is there a Clubhouse?
— If Yes, square footage:
— If Clubhouse, Construction Type:
— If Clubhouse, Replacement Cost Limit:
RECREATION SECTION
Are there any children's playgrounds on the premises? 
— If yes, describe: 
Are there any exercise facilities on the premises? 
— If yes, describe: 
Any swimming pools or spas on the premises? 
— If pool, number of pools: 
— If spa, number of spas: 
— If yes, are they completely fenced with self-closing and self-locking gate devices? 
— If yes, are there any water slides or diving boards on the premises? 
— If yes, is the water depth clearly marked on the exterior of the pools? 
Are there any saunas on the premises? 
— If yes, does it have "Panic Bars"? 
UNDERWRITING SECTION
Involved in any litigation regarding the construction, maintenance or service of premises? 
Are there any construction defects known to you relative to the location being insured? 
Are there any occupancies other than habitational? 
— If yes, describe: 
— If yes, square footage: 
Are there smoke detectors in all living units, hallways and stairways? 
— If yes, are they hard wired or battery operated? 
— If battery, do you change at least annually and keep a log? 
Are all tub and shower surfaces of a "non-slip" type? 
Is all tub and shower glass made with "safety glass"? 
Are all premises fenced and is access restricted or controlled? 
Do you rent any apartments on other than a Monthly basis? 
— If yes, describe: 
Are there any subsidized units and/or rental assistance units in the apartment? 
— If yes, what is the percentage? 
Are there railings on any balconies or walkways on the premises? 
— If yes, are vertical slats built/located 6 inches OR LESS apart? 
— If yes, are there any horizontal slats on the premises? 
Are background checks required on all new employees? 
Is this location within 500 feet of any river, lake or ocean? 
— If yes, describe: 
Are there any lakes, streams, or ponds on the premises? 
— If yes, describe: 
Are there any "Wood Shake" roofs at this premises? 
— If yes, what percentage of the roof is "Wood Shake"? 
Are all enclosed stairwells equipped with self-closing doors & emergency lighting? 
Is there a resident or on-site manager on premises? 
Is the insured responsible for any public streets or roads? 
Are animals allowed? 
— If yes, list types, breeds, controls, or other guidelines: 
Does tenant lease agreement permit "manager walk thru" of units at least quarterly? 
Any security services provided? 
— If yes, describe: 
Does this building have any pressure vessels? 
— If yes, describe pressure vessels: 
— If yes, what is the PSI? 
— If yes, what is the most recent certification date on the Vessel? 
Have arrangements been made for snow and ice removal from walks and parking area? 
— If yes, is it done by employees, or are others contracted to do the removal? 
Are there any outside steps up to second floor or higher floors or levels? 
— If yes, are the steps covered? 
Are emergency telephone numbers gotten from tenants in case of an emergency? 
— If yes, work telephone numbers? 
— If yes, a telephone number of a relative or friend? 
Does the apartment have maintenance employees on staff? 
— If yes, number of maintenance employees on staff: 
— If yes, are these employees on premises or available 24 hours for emergencies? 
Are tenants required to carry liability and/or property insurance on their apartment? 
— If yes, are copies of coverage required and kept on file? 
— If No, are tenants given any info regarding the need for property & liability coverages? 
Are fire extinguishers present on each floor of the apartment complex? 
— If yes, are they well marked, and have they been inspected & tagged in the past year? 
Does the apartment supply washers & dryers for tenants use? 
— If yes, what is the charge made per load? 
— If yes, what is the average annual income from washer & dryer charges? 
What percentage of the units are Handicapped Accessible? 
List all utilities that are paid for by the insured/apartment: (Water, Electric, Gas, etc.) 
Is there any Aluminum Wiring or Asbestos in the building or complex? 
What is the estimated percentage of tenants that are College Students? 
Are complaint and repair logs maintained for the building? 
Does a professional management firm manage the apartment or complex? 
Have there been any losses in the past 3 years? 
— If yes, describe: 

Remarks:

This web site provides a simplified description of coverages and is not a statement of contract.
Completing this questionnaire does not bind coverage for the applicant, the insurer, or program manager. Coverage may not apply in all states.