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Information Coverage Effective Date * Name on Condo Deed * Your Name * Your Email Address Mailing Address * City * Postal Code * Location Address * Location City * Location Postal Code * Preferred Method of Contact Email Phone Text Condo Type High Rise Townhouse (not freehold) Year Building Built * Square Feet of Unit * Prior Insurance Prior Insurance Yes No Insurance Company * Policy # * Does Tenant have insurance on their contents? Does Tenant have insurance on their contents? Yes No If No it would be in your best interest to insist they have one. They should send you email acknowlegement that a policy is in place. Any insurance claims in past 5 years? Any insurance claims in past 5 years? Yes No Date of Loss Type of Claim Amount Paid Add Additional Location? Information Name on Condo Deed Location Address Location City Location Postal Code Condo Type High Rise Townhouse (not freehold) Year Building Built Square Feet of Unit Add Additional Location? Information Name on Condo Deed Location Address Location City Location Postal Code Condo Type High Rise Townhouse (not freehold) Year Building Built Square Feet of Unit Add Additional Location? Information Name on Condo Deed Location Address Location City Location Postal Code Condo Type High Rise Townhouse (not freehold) Year Building Built Square Feet of Unit Add Additional Location? Information Name on Condo Deed Location Address Location City Location Postal Code Condo Type High Rise Townhouse (not freehold) Year Building Built Square Feet of Unit Add Additional Location? Information Name on Condo Deed Location Address Location City Location Postal Code Condo Type High Rise Townhouse (not freehold) Year Building Built Square Feet of Unit Extra Information
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