Transcription of Acord Homeowner Application - Abram Interstate Insurance
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Acord Homeowner Application - Abram Interstate Insurance
Acord CORPORATION 1981-2006. All rights 1 of 4 The Acord name and logo are registered marks of ACORDACORD 80 (2006/10)COMP. DATE:COCFARMSEASONALSECONDARYPRIMARYUSAG E TYPEGROUNDSWIMMING POOLYESNOAPPROVEDFENCEDIVINGBOARDABOVEGR OUNDIN -SLIDENONEOIL STORAGE TANK LOCATIONABOVE GROUND ONMASONRY FLOORABOVE GROUND NOTON MASONRY FLOORABOVEGROUNDBELOWGROUNDINDOORSOUTDOO RSFIRE DISTRICT / CODE NUMBERFIRE / EC RATEFIRE EXTNEIGHBORSVACANTUNOCCDEADBOLTVISIBLE TOTENANTOWNEROCCUPANCYHOUSEKEEPING CONDITION# WKSRENTEDNOYESOCCUPIED DAILY?SPECCLASSRATING# ROOMS# APTS$MARKET VALUE$REPLACEMENT COSTHEAT TYPENONEPRIMARY:SECONDARY:ROOF MATERIALNONECLOSEDOPENFOUNDATIONCIRCUIT BREAKERSNOYESFUSESNOYESYR BUILTSQ FTSUBURBWITHIN PROTFIRE DISTWITHINCITY LIMITSWITHINDWELLING LOCATIONNUMBER OFFIREDIVSUNITS INFIRE DIVTERRCODEDATE HEATING SYSTEMLAST SERVICEDNUM OF AMPS(ELEC SYST)ALUMINUM WIRINGYESNOKNOB & TUBE ORCONDITIONPLUMBING SYSTEMANY KNOWN LEAKSYESNOPLUMBING SYSTEMDATE/PRICEPURCHASERESHSEHLD#ILIES# FAM-RENOVATION TYPEWIRINGPLUMBINGHEATINGROOFINGEXTERIOR PAINTPART COMP YEARLOCALDIRECTCENTRALBURGLARTEMPSMOKESY STEMPROTECTION DEV
acord 80 (2006/10) page 2 of 4 is the building entrance locked? is there a security attendant? is there a manager on the premises? renters and condos only:
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