Landlord Insurance Quote from Catalli Insurance Brokers

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We generally only offer this coverage for clients with Auto and/or Home coverage through our agency.

Personal Information

First Name ✶

Last Name ✶

Street Address ✶

City ✶

State ✶

ZIP ✶

Phone

Email ✶

Date of Birth ✶

Property Information

Property Address

Street Address ✶

City ✶

State ✶

ZIP ✶

# Units ✶

units

Square Footage

sq ft

Year Built

Quality ✶

Fire Hydrant Within 1,000 Feet?

Yes

Swimming Pool or Hot Tub?

Yes

Property Updates

Roof Type ✶

What type of roof?

Age of Roof

yrs

Is the property on circuit breakers? ✶

Yes

Unsure

Interior & exterior electrical panels/breakers ✶

Are the interior or exterior electrical panels/breakers any of the following makes: Federal Pacific Stab-Lok or Zinsco (including, but not limited to, Zinsco style panels produced under the Magnetrip, Sylvania, and Challenger names)?

Yes

Unsure

What make and are you planning to replace? (provide details) ✶

Age of Electrical

yrs

Age of Plumbing

yrs

Age of Heating

yrs

Insurance Policy Information

Is this a new purchase? ✶

Yes

Expected Closing Date

Currently Insured? ✶

Yes

Current Insurance Policy

Current Insurance Company ✶

Current Policy Expiration

Current policy declarations page

Helps us provide comparative quotes

What is the reason for no prior insurance? ✶

Cancelled by previous carrier

Missed payment

Did not want to carry coverage

Other

Provide additional details for no prior insurance ✶

Any claims filed in past 5 years? ✶

Yes

Provide details of claim including date of loss and payout ✶

Does tenant carry Renters Insurance? ✶

Yes

Managed by Property Management Company with active real estate license? ✶

Yes

Is property ever used as a short-term rental? ✶

Yes

Is residence held in a Trust or any other business entity (i.e. LLC, LP, etc.)? ✶

Yes

Which type and provide name ✶

Current Auto Insurance Carrier ✶

Current Home Insurance Carrier ✶

Comments or Questions

I understand that insurance coverage is not bound or altered until I receive confirmation by an authorized representative of Catalli Insurance Brokers ✶

Subject

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