Rental Property Review *Please complete only sections applicable to your policyConfirm Personal InformationName of individual completing this form: First Last Best phone number to reach you:Email: Marital status: single married If married, indicate spouse's name:Occupation:Spouse's occupation, if applicable:Home InsuranceProperty AddressCurrent Mortgage Company & Loan NumberNew Additions or RenovationsYear roof has been replacedRoofing Material Asphalt Shingles Tile (Ceramic or Tile) Steel/Metal other Updates to:WiringPlumbingHeating/ACSiding Please check applicable Basement finish Home remodel Sump pump Deck Fence Hot tub Swimming Pool Trampoline Garage Solar Is your home still occupied by a tenant? Yes No Security InformationNote: There maybe discounts available, based on the information provided. Please indicate what applies to you: Central Alarm System (ie. alarm monitored by a 3rd party) Burglar Alarm Fire Alarm Fire Extinguisher Miscellaneous InformationI allow dogs located on my rental property: Yes No If yes, how many and what breed?If yes, has your tenant's dog(s) ever bitten anyone? yes No What is your monthly rent charged to your tenant?Other Insurance NeedsBolder Insurance would be happy to discuss your insurance needs in more detail. Please indicate any topics of interest to you: Increased Personal Liability Limits (for instance Auto, Home, or Umbrella) Insurance for your Business needs Business auto insurance Life Insurance Home Auto Flood Insurance Earthquake Insurance Other (describe)We recommend that your tenant obtain Renter's Insurance to cover their personal belongings, liability, loss of use and more. Visit www.Bolderinsurance.com to learn more. Δ
