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Hotel/Motel Insurance
 
Fields marked (*) are mandatory.
General Information
Name of Business*
Contact Name*
Mailing Address*
City*
State*
Zip*
Business Phone*
Fax
Best Time To Call
Contact Email Address*
Insured ls  
How Long in Business*
Property Information
Street Address*
City*
State*
Zip*
Year Built*
 
# of Units*
# of Stories*
Total Building Square Footage:*
Building Construction
Type of Parking:
Type of Roof
Year Roof Last Updated
# of Pools
Are pool(s) Fenced
Are there diving boards
Is there a pool slide
# of in-room Jacuzzis
# of Kitchenettes
Type of Electrical
Year Electrical Last Updated
Type of Heating
Year Heating Last Up dated
Type of Plumbing
Year Plumbing Last Updated
Automatic Fire Sprinklers
On All Floors
Fire Alarms  
Smoke Detectors
Burglar Alarms
On-Site Security
Total Sq. Footage of Restaurant
Restaurant Operated By
Liquor Receipts
Bar Serves
Total Sq. Footage of Retail Stores
Total Sq. Footage of Banquet Halls
Total Sq. Footage of Exterior Glass
Distance to Lake, River, Ocean
Hotel is owned by
Is the hotel part of a franchise
Desired Coverages
Building Amount
Annual Income
Contents Amount
Deductible
Exterior Glass
Accounts Receivable
Employee Dishonesty
Employee Benefits Liability
Money & Securities
Valuable Papers:
Building Ordinance
Agreed Amount Endorsement
Inflation Guard
Outdoor Sign Value
Earthquake Sprinkler Leakage
# of Additional Insureds
General Limit Liability
Guest Medical
Liquor Liability
Non-owned/Hired Auto Liability
Inn-Keepers Legal Liability
Tenant Fire Legal Liability
Garage Keepers Collision Value:
Garage Keepers Collision Deductible
Garage Keepers Other Than Collision Value
Garage Keepers Other Than Collision Deductible
Current Insurance Information
Current Insurance Company
Policy Expiration Date
# of claims in last 3 years:
List all claims below in past 3 years
Type of Claim
Date
Amount Paid
Type of Claim
Date
Amount Paid
Type of Claim
Date
Amount Paid
Type of Claim
Date
Amount Paid
Type of Claim
Date
Amount Paid
Additional Comments
Please give any additional comments you feel appropriate for this quotation.