CGE 094 (2/11) Apartments, Condominiums Questionnaire Copyright 2014, CapSpecialty, Inc. Page 1 of 2
APARTMENT, CONDOMINIUM, DWELLING & TOWNHOUSE QUESTIONNAIRE
Please answer all questions. Submit this questionnaire with a completed ACORD application and prior carrier loss runs.
This questionnaire is not required if the building is less than 30 years old and being written in CIC.
Named Insured:
Website:
PROHIBITED CIRCUMSTANCES
If any questions in the section below are answered “YES,” you are not eligible for coverage.
1. Are barbeque grills allowed on outside balconies or decks?
Yes No
2.
Is the building a fraternity or sorority house?
Yes No
3.
Is the building in the process of or planning renovations in the next year?
Yes No
(CSIC: GL may be eligible, submit for coverage consideration. Property
may be eligible
in either co
mpany but needs to be written on a builder’s risk policy)
4. Is the annual vacancy rate greater than 20%?
Yes No
5.
Do you contract with or employ armed guard se
rvices?
Yes No
If any questions in the section below are answered “NO,” you are not eligible for coverage:
6. Are references checked on all applications?
Yes No
GENERAL INFORMATION
1. Type of Property: Apartment Condominium
Multi Family Dwelling(s) Single Family dwelling(s)
2. Does the owner or a manager live on the premises?
Yes No
3.
Are there any commercial occupants other than
apartments?
Yes No
a.
What type of commercial occupant
s?
Restaurant Mercantile Office
b.
Is the area of all mercantile operations greater than 15% of the total building area?
Yes No
4. What are the average monthly rents? 1 Bedroom: $
2 Bedroom: $
3 Bedroom: $
5. Have you declared bankruptcy within the last 5 years? Yes No
6.
Percent of total units for each of the following:
a. Student
occupied?
%
b. Subsidized or HUD? %
c. Senior housing? %
d.Vacant? %
