Open Market Property Application
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“ OPEN MARKET” PROPERTY APPLICATION
TO: ROBERT FLEMING INSURANCE FAX: 011 44 20 7623 6175 BROKERS LTD., LONDON. (Or 011 44 20 7626 0400)
ATTN: Roger Wardale DATE:
FROM: ……………………………………………. FAX:
______
1) NAME OF ASSURED:......
2) LOCATION(S) OF RISK:......
3) DESCRIPTION OF OPERATIONS:......
4) EFFECTIVE DATE......
5) SUM INSURED REQUIRED VALUE $ CO-INSURANCE %
BUILDING ...... CONTENTS ...... LOSS OF EARNINGS ...... ANY OTHER INTERESTS______...... (please specify) ______......
6) R.C.V./A.C.V. BASIS OF VALUATION 7) PERILS REQUIRED......
8) TOTAL VALUE (if first loss) $......
9) CONSTRUCTION...... AGE......
10) CONDITION OF BUILDINGS ……………………..UPDATES......
11) PRIVATE PROTECTIONS......
12) PROTECTION CLASS......
13) % OCCUPANCY (apartments)...... % HUD/Subsidized......
14) FINANCIAL STATUS......
15) HOUSEKEEPING/MANAGEMENT......
16) TYPE OF NEIGHBOURHOOD (RE CRIME/VMM)......
17) TYPE OF CLIENTELE......
18) NUMBER OF YEARS IN BUSINESS......
19) DETAILS OF ADJACENT EXPOSURES......
20) PROPERTY LOSS RECORD PAST 5 YEARS......
21) ANY OTHER PERTINENT INFORMATION......
22) TARGET PRICE...... ………......