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Homeowners Association Questionnaire

Homeowners Association Questionnaire

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Recent life changes can open up your eligibility for discounts or leave you inadequately covered. We can help you keep your insurance coverage up-to-date by conducting an insurance review. Please answer all questions. Thank you for your time!
Named Insured:

Prohibited Circumstances

Does the applicant have it’s own volunteer fire department, sheriff, police or rescue squad?
Does the risk operate/maintain a sewage treatment facility or water treatment facility?
Does the applicant have a garbage dump?
Does the applicant have a private airport?
Does the applicant have an ice skating rink exposure?
Is the developer or contractor a named insured?
Does the applicant employ any security guards/patrol (independent contractors are ok)?
Does the applicant contract with armed security guards?
Does the applicant have a Class I or II dam (greater than 40 feet tall, have a storage Yes No volume greater than 500 acre feet or have a potential downstream hazard of injury or death to people, damage to homes, businesses, highways, railroads or other dams)?
Does the applicant allow time shares?

General Information

Do you rent your club house to others?
Does the risk have a water dam exposure?

Other Exposures

1. Complete each of the following. Number of:
Athletic Fields or Courts
Swimming Pools
Whirlpools
Saunas
Lakes, Ponds, or Reservoirs
 
1. Complete each of the following. Number of:
Beaches
Boat Docks or Slips
Miles of Road Maintained by Applicant
Clubhouses
Parks or Playgrounds
 
MM slash DD slash YYYY
This field is for validation purposes and should be left unchanged.

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