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Printers & Publishers

* - Denotes Required Field

*First Named Insured
 
Premises
*Street
*City
*State
*Zip
*# of Stories
*# of Units
*If coop/Condo, # Sold
*Construction
*Building Value
# of Elevators:
Floor over basement fire-resistive?
Yes No
Stairwells enclosed?
Yes No
Standpipe in stairwells?
Yes No
Central Air conditioning?
Yes No
Emergency Evacuation Plan in Place?
Yes No
Indoor parking?
Yes No
If so, number of cars?
Emergency lighting in stairwells?
Yes No
Exterior fire escapes?
Yes No
Hard-wired smoke detectors?
Yes No
If leased, is applicant an additional insured on operator's policy?
Yes No
Professional offices?
Yes No
If yes, seperate entrance?
Yes No
Health Club?
Yes No
Tennis, paddleball or basketball courts?
Yes No
Swimming pool?
Yes No
If yes, diving board?
Yes No
Lifeguard?
Yes No
Any of the above recreational facilities leased to an independant operator?
Yes No
If leased who is operator?
If leased, is applicant an additional insured on operator's policy?
Yes No
Limits
Commercial Occupants?
Yes No
If yes, # of square feet
Describe them
Dry cleaning on premises?
Yes No
Super reside on premises?
Yes No
Doorperson 24hrs/7 days?
Yes No
If part-time, indicate hours:
Describe other security:
TV Monitors Intercom Buzzer
Burglar alarm on all unattended entries?
Yes No
Other note:
When and how was asbestos abated?:
When and how was lead paint abated?:
Was roof resurfaced?:
Describe any plans to update roof?:
Is a formal written Building evacuation plan provided to all occupants??
Yes No
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