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APARTMENT SUPPLEMENT
APARTMENT SUPPLEMENTAL APPLICATION
Agency Name  : 
Agent Phone Number  : 
Agent Fax Number  : 
Agent E-Mail Address  : 
Applicant's Name  : 
Proposed Policy dates:
Mailing Address : 
Business Location : 
Limits Requested : Deductible Requested : 
How long in business under this name?    
Years experience in this field  :      
Business structure : Individual Partnership    
  Corporation Other      
GENERAL INFORMATION
Age of Bldg. # of Bldgs :      
. # Stories # Units :      
% Occupied  :       
Construction / last updated :   
If over 10 years, detail : 
If aluminum wiring, have all outlets been pigtailed and checked by a licensed electrical contractor within the past 5 years?             YES        NO
       
# Years Owned  :      
Condition of Property Good             Average    Poor
Surrounding Area Improving    Stable    Declining
FIRE/SAFETY INFORMATION
Hallways / Stairwells open or closed :   
# of Exits  :   
Fire doors and panic hardware? : YES     NO  
Is there a central station?  :            YES     NO    
If yes, is it monitored to desk?  :    YES    NO    
Are heat / smoke detectors    :       Hard wired      Battery  
How often are detectors tested?  :      
 Is risk sprinklered? YES    NO
How often are batteries replaced?  :      
If yes, describe which areas  :  
SWIMMING POOL INFORMATION
Check here if applicable,      Number of pools :   
Are pools fenced from all units?    YES NO If yes, what is height of fence? :
Self-closing gate?     YES NO    
Any structures within 10' of edge of pool? YES NO    
Is there a diving board or slide? YES NO If yes, what is height of board:
Depth markers? YES NO    
Shepard's hook/ring nearby? YES NO    
SECURITY
Sliding glass doors equipped with additional locks?
YES NO
  
Do entry doors have keyless deadbolts?                      YES NO  
Do entry doors have peepholes?                                     YES NO  
Are there any security guards on premises?               YES NO  
If yes, provide fall details including whether armed or unarmed. off-duty police, independent firm (which provides certificates?) or employees and if there is any non-cash compensation.
Are there any fences and / or gates surrounding the property?                  YES NO
Are criminal checks done on employees?                                                        YES NO
Are criminal checks on prospective tenants?                                                  YES   NO
Have there been any previous incidents of physical or   sexual assault? YES NO
OTHER
Confirm that lease/rental agreement makes no warranties with regard to security and that leasing agents / employees are instructed to advise potential and current tenants to dial 9-1-1: YES NO
   
Do you have units with subsidies or government funding
(HUD, rent subsidies, rent funding or other)? :
No. of units      :       
Describe type : 
Percent rented to Students :     
Percent rented to elderly      :     
Any of the following? Please describe all yes answers in detail below
Baseball Fields
 : 
 YES NO Clubhouse
: 
 YES NO
Basketball Courts
: 
 YES NO Convenience Store
: 
 YES NO
Racquetball Courts
: 
 YES NO Exercise Facility     
: 
 YES NO
Restaurants
: 
 YES NO Saunas / Spas   
: 
 YES NO
Bathing Beaches
: 
 YES NO Lakes     
: 
 YES NO
Playgrounds
: 
 YES NO Lifeguards   
: 
 YES NO
Bike / Horse Trails 
: 
 YES NO Boat Docks/Slips
: 
 YES NO
Parks
: 
 YES NO Special Events  
: 
 YES NO
Security Guards
: 
 YES NO Streets / Roads
: 
 YES NO
Water Works
: 
 YES NO Sewage Treatment Plants
: 
 YES NO
Tennis/ Valley Ball Courts
:
 YES NO      
       
 
Details
    
PRIOR CARRIER INFORMATION
Year Carrier Policy# Limits Premium #Claims TotalPd TotalReserve*
       
* Attach separate sheet with details.
Any person who knowingly and with intent to defraud any insurance company or other person files an application for insurance containing false information, or conceals for the purpose of misleading, information concerning any fact material thereto, commits a fraudulent insurance act, which is a crime. This application does not bind any of the parties to complete the insurance transaction.
       
  Turner General Agency, Inc.
Phone: (888) 443.7932 ~ (972) 290.7200		 Fax: (972) 203.8206 Email: Brett Turner at 
brett@turnercompanies.com  		 

 


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