Commercial Coverage - RFQ- Building Coverage

Submisson Building

Contact information:

Date In:

* required

Present Date:

QP In 360

* required

Contact:

Referred:

Mailing:

City/State/Zip:

Home #:

Work#:

Cell #:

Fax#:

Email:

FNI:

Transaction Profile:

ListingAgent:

Listing Tele:

BuyersAgent:

BuyersTele:

Banker:

BankersTele:

Escrow:

EscrowTele:

PropManager:

PropMgrTele:

Building Profile:

Prop Name:

Site Address:

Prop Type:

# Apt Units:

City/State/Zip:

Situation?:

Year Built:

# of Stories:

# of Buildings:

Apt Sq Ft:

LRO Sq Ft:

Total Parking #:

Parking Type:

Claim History 5yr

Construction Profile:

Ele/Update:

CB/Fuse:

PlumbUpdate:

PlumbType:

HVAC Update:

HVAC Type:

Roof Update:

Roof Type:

Vac/Stu/Sec8:

Sprinklers:

Const Type:

Reto Notes:

Life & Safety:

Balconies

Railings <4 inch

Elevators

Smoke & Fire

Pull Fire

Cent Stat Hook

Annunciator

Standpipe

2 Ext Floor

Outside Egress

Emerg Lit

Light Exit

Armed Sec

Watchman

Doorman

Enclosed Stair

Coverage Profile:

Comm Tenants

List Comm Tenants/Sqft each:

Short Story:

Current/Limits Blg Value: Bus Income: BPP:

* required

Other Coverage Request/Held/Cost UMB: Earthquake: Building Ord: Equip Breakdown:

* required