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Our Flood Plus Application (All Risks, Ltd)

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FloodPlus Quote Sheet
300 Arboretum Place, Suite 410 • Richmond, Virginia 23236
Phone: 877-275-9578 • Fax: 804-330-9485
Email: QuickHomeQuotes@allrisks.com • www.allrisks.com
Important: This quote is a non-binding price indication that is subject to a signed application and approval from our office.
No coverage is bound until confirmed by our office.
Agency Information
Agency:
Agency Contact:
All Risks Broker #:
Phone:
E-mail:
Insured Information
Insured Name:
Co-Applicant:
Phone:
Occupation:
Risk Address:
Mailing Address (If Different):
Risk Details
Occupancy Type:
Primary
Secondary
Annual Rental
Short-Term/Seasonal Rental
Vacant
Vacant Renovation
Builders’ Risk
Construction / Cladding Type:
Frame
Masonry
Stucco
EIFS
Brick Veneer
Log
Dwelling Replacement Cost Value:
ACV RCV
Requested Effective Date:
Year Built:
Square Footage:
Number of Floors (including basement/enclosed area):
Is the building over water? No Partially Entirely
Does the building contain asbestos? Yes No
Risk Elevation – See attached document for reference
If building is elevated:
Foundation Type:
Piers/Posts/Piles
Reinforced Masonry
Reinforced Shear Walls
Solid Foundation Walls
If building is NOT elevated:
Foundation Type:
Foundation Wall
Slab on Grade
Slab on Fill
Basement/Subgrade Enclosure? None Finished Unfinished
Height above ground of the lowest occupied floor: Feet
Crawlspace?
Enclosure?
Garage?
None Finished Unfinished
None Finished Unfinished
None Finished Unfinished
Flood Loss History
Have there been any flood losses at the risk location within the past 5 years?
Yes No
If yes, has the building been elevated since the previous flood loss?
Yes No
Date of Loss
Description
Amount Paid
Open/Closed
Quote Options - You can select more than one option to be quoted
Quote Option
Dwelling
Contents
Other Structures
Loss of Use*
Full Value Option
Replacement Cost
Value of Dwelling
Up to 70% of Dwelling
Replacement Cost Value
10% of Dwelling
Replacement Cost Value
20% of Dwelling
Replacement Cost Value
NFIP Limit (Dwelling Only)
$250,000 Limit
Excluded
Excluded
Excluded
NFIP Limit (Dwelling &
Contents)
$250,000 Limit
$100,000 Limit
Excluded
Excluded
Deductible
$1,000 $2,000 $3,000 $5,000 $10,000 $25,000
*Loss of use is limited to 5% for homes located in V-Zones and excluded for Vacant and Builders’ Risks.
05.19
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Our Flood Plus Application (All Risks, Ltd)

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Completed 15 July 2020

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