Step 1 of 4 25% Property Management ApplicationName of Company*Contact Name*Company Address* Street Address City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Phone*E-mail* FEIN #Year Business StartedType Corp Partnership LLC Sole Proprietorship Employee Breakdown Full Time Part Time Gross Income Property ManagementCondo/Homeowner Association# UnitsProjected Next 12 MonthsApartments# UnitsProjected Next 12 MonthsResidential Homes# UnitsProjected Next 12 MonthsCommercial Buildings# BuildingsProjected Next 12 MonthsGross Real Estate Sales IncomeResidential Sales# Homes Sold a YearProjected Income Next 12 MonthsDoes the Applicant have ownership interest in any of the properties managed? Yes No If yes, please provide details here:*Describe your Contract usages Always Used Sometimes Used Never Used Does your contract contain both hold harmless and indemnification clauses? Yes No Does your contract clearly define the scope of services that are being performed? Yes No Current InsuranceErrors and OmissionsInsurance CoLimit of LiabilityRetro DateDeductibleGeneral LiabilityDoes it cover more than just things in your office? Yes No Insurance CoLimit of LiabilityRetro DateDeductibleTenant Discrimination AND/OR EPLI Employment Practices Liability InsuranceInsurance CoLimit of LiabilityRetro DateDeductibleCyber CoverageInsurance CoLimit of LiabilityRetro DateDeductibleIn the past 5 years, have you ever been Canceled or Refused renewal on any of your insurance? Yes No In the past 5 years, have you had any claimed, suits, complaints involving Errors and Omissions, Discrimination, Fair Housing Act Violations, Wrongful eviction, EPLI, or Wrongful Termination, been brought on you? Yes No General Liability / Property CoveragesIs the office located at one of the sites you manage? Yes No Do you own the building? Yes No Gross Sqft of officeBusiness Personal Property Limit (contents)Does organization have coverage for Hired/Non-owned Autos? Yes No Do you require evidence of insurance from employees? Yes No Does organization require agents to carry a minimum of $100,000/$300,000/$50,000 Personal Auto Liability Yes No
