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Vacation Rental Insurance Form
"
*
" indicates required fields
Name of person or entity owning the property
*
Contact Name
*
First
Last
Owner Birth Date
Month
Day
Year
Owner of property birth date, if desiring a personal lines quote for the property.
Mailing Address
*
Street Address
Address Line 2
City
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
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New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
Email
*
Phone
*
Do you use a professional property manager?
Yes
No
If, so who and what is their address?
If no, do you plan to use one?
Yes
No
Do you advertise your vacation rental online?
Yes
No
If yes, what is the link?
If no, do you plan on listing your property online?
Yes
No
Property Address
*
Street Address
Address Line 2
City
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
If applicable, what is the name, or DBA, of your vacation rental?
Is it Part of a Condominium Association?
Yes
No
Is there an HOA policy in place for the structure?
Yes
No
What is the deductible on the HOA policy?
Is this rental also your primary residence?
Yes
No
Does this rental offer a loft or bunk bed that are accessed by a ladder?
Yes
No
Do you own a dock or pier at this location?
Yes
No
Does this rental have an active noise monitoring/decibel system?
Yes
No
Has there been a covered property claim at this location in the last three years?
Yes
No
Expected annual income from rentals?
*
Building Type:
Duplex
Single Family
Townhome
Other
Construction Type:
Frame
Brick
Reinforced Concrete
Other
Number of bedrooms available to guests?
Number of stories?
Do you have a central station fire alarm system?
Yes
No
Does this building have sprinklers?
Yes
No
Estimated Square footage?
*
What type of Roof Material?
Year built?
Has the building been Updated?
Yes
No
Building Rebuild value?
Value of contents in the property?
Liability limit requested?
Yes
No
How did you hear about Landmark?
Red Rock Vacation Rentals
Internet
Arcadia Vacation Resort
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