General: Loss Control: Accounting: Misc: Project Specific Data Select type of Policy Project Wrap-Up: requested: Specific: Estimated Project total Gross Receipts: Estimated Project total Construction Cost: Estimated Time Required to Complete and sell all units in months: _________________ Estimated Start Date Estimated Completion Date __________________ Name of Project: Physical Address of Project: Detailed description of Project (including number of buildings, number of building construction & number of floors: Building # of # of Units Number of Stories Estimated Type of Construction Protection Estimated Total Type Buildings per Sale Price Class Project Receipts Above Below Building Per Grade Grade Home/unit Wood Frame Joisted Masonry Single Family Masonry Non-Combustible Dwellings Square Footage Per Bldg: Wood Frame Joisted Masonry Multi Family Masonry Non-Combustible Dwelling Other: Square Footage Per Bldg: Wood Frame Joisted Masonry Condo / Masonry Non-Combustible Mixed Use Other: Square Footage Per Bldg: Wood Frame Joisted Masonry Apartment / Masonry Non-Combustible Commercial Other: Square Footage Per Bldg:
General: Loss Control: Accounting: Misc: Project Specific Data Select type of Policy requested: Project Specific: Wrap-Up: Estimated Project total Gross Receipts: Estimated Project total Construction Cost: Estimated Time Required to Complete and sell all units in months: _________________ Estimated Start Date Estimated Completion Date __________________ Name of Project: Physical Address of Project: Detailed description of Project (including number of buildings, number of building construction & number of floors: Building Type # of Buildings # of Units per Building Number of Stories Estimated Sale Price Per Home/unit Type of Construction Protection Class Estimated Total Project Receipts Above Grade Below Grade Single Family Dwellings Wood Frame Joisted Masonry Masonry Non-Combustible Square Footage Per Bldg: Multi Family Dwelling Wood Frame Joisted Masonry Masonry Non-Combustible Other: Square Footage Per Bldg: Condo / Mixed Use Wood Frame Joisted Masonry Masonry Non-Combustible Other: Square Footage Per Bldg: Apartment / Commercial Wood Frame Joisted Masonry Masonry Non-Combustible Other: Square Footage Per Bldg:
Small-Wrap-AIX-Insur-Co.-Application.docx