< BACK TO RISKS  PRINT THIS FORM
Property Insurance Underwriting Survey

General Information:
Exact Name of Applicant:
Submitted Date:
Effective Date:
Street or P.O. Box:
City:
State:
Zip:
Contact:
Telephone:
Email:
Business or occupation of applicant:

Property Description & Coverage Schedule:
Location or Building #1 Location or Building #2 Location or Building #3
Building $ $ $
Contents $ $ $
Tools $ $ $
Misc. Equipment $ $ $
Employee Tools $ $ $
EDP Equipment $ $ $
Area in Square Feet
Type Construction-Bldg.
Type Construction-Roof
Year Construction-Bldg.

Airport Name:
Identifier:
Address of Building:

Airport Fenced: Yes No
Alarm System: Yes No - Type:
Fire Department on Airport: Yes No
Distance to Fire Department:
Tower: Yes No - Hours:
Repair and Service Work in Hanger: Yes No

Describe:
Painting in Hanger: Yes No

Describe:
Occupancy
(type of contents kept in building):
Name and Address of Mortgagee:

Prior Insurance (Last 3 years):
Policy Term Name of Company Policy Number Premium

Loss Detail (Last 3 years):

< BACK TO RISKS