Commercial Structure Addition Form

**All additions will be processed the date that we receive the request in our office. You must complete one form per property, if you have have multiple additions. **

Name Insured(Required)

Date(Required)

Policy #(Required)

Email(Required)

Building Description (Name)(Required)

Please describe what the structure is used for:(Required)

Attach Photos of Buildings **Photos of all buildings are required**(Required)

Drop files here or

Max. file size: 100 MB, Max. files: 10.

Type of Coverage(Required)

Contractor

Estimated Completion Date

Type of Builders Risk

Construction Type(Required)

Construction Year(Required)

Exterior Square Foot(Required)

Building Upgrades

Exterior Siding(Required)

Other Siding-Please state below

Roofing Material(Required)

Other Roofing Material-Please state below

Geometric Shape(Required)

Basement(Required)

Exterior Decks(Required)

Is Premises equipped with automatic sprinkler system?(Required)

Yes

No

Last time automatic sprinker system inspected(Required)

Describe any safety and/or fire measures you have implemented:

Vacant:(Required)

Yes

No

If yes, how long? ( # of days, or # of months, 3 or # of years)(Required)

Stated Building Value(Required)

Business Personal Property Limit(Required)

**All values will be evaluated by the Underwriting Department** Please note that this BPP coverage is for Personal Property that is within 100ft of the structure.

Business Income Limit

Address(Required)

Physical Address City State ZIP Code

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Phone

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