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Association and PUD Information

Name of Association

Location Address

City, State, Zip

Contact Person

Management Company

Phone

Fax

Email

Number of Buildings

Total # of Units

Age of Complex

# of Stores


1.Do buildings have sprinklers: Yes   No
2.Elevators: Yes   No   If yes, how many?
3.Roof Type: Shake   Tile   Composition   Other
4.Garaging: Attached   Carports   Stand Alone   Subterranean   Tuck Under
5.# of Pools/Spas:   Are they fully fenced? Yes   No
6.# of Clubhouses:   Square footage
7.# of Playgrounds:
8.Lakes or Ponds: Yes   No
9.Private Streets: Yes   No
10.Sport Courts: Yes   No
Type of Security Gates or Guards:

Comments (any other common property or amenities):




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Note: It is most helpful to have your current insurer’s declaration page and the insurance section of the CC&Rs. A three year loss history is mandatory. Coverage cannot be bound unless loss runs are provided.