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Community Association Request for Insurance
First name
*
Last name
*
Email
*
Phone number
Management Company
*
*Write NA if none
Property/Association
*
Does this property have a preventative maintenance budget?
Yes
No
Type
Please Select
COA
HOA
Cooperative
Other
# of Units
Renewal Date
Month
/
Day
/
Year
Briefly Summarize Five-Year Loss History
*This information is needed to provide quotations of insurance.
Would you like us to quote more than one property?
Yes
No
File Upload - Certificate of Insurance
File Upload - Income Statement
File Upload - Bylaws
File Upload - Balance Sheet
File Upload - Site plan (if available)
Anything else we should know?
Request Quote