OPERATIONS/ OCCUPANCY
`
|SPECIAL ATTENTION | | |
|None |
| |
|OCCUPANCY |Person interviewed | |Title | |
| |
|Insured is a: | Corporation | Partnership | Individual. | |
|Insured is the Bldg.: | Owner | Tenant |At this Location for the past | Years. |
|Insured Occupies: | All | None -Absentee Landlord | Part - Describe: | |
| |
| NA |Monday |Tuesday |Wednesday |Thursday |Friday |Saturday |Sunday |
|Hours: | | | | | | | |
| |
|OPERATION/ HABITATION | |
| |
| |
|PRODUCTS | None |
| | Professional | Food Handler | Other | |
| |
| |
|OFF- SITE OPERATIONS | None |
| | | | | | |
| Sales | Installation | Warehouse | Deliveries | Repairs | Surveys/ Inspections |
| Other: | |
| | |
|ADDITIONAL LOCATIONS | |
| None | |
|RECOMMENDATIONS | |
| |
|None Noted |
| | |
| |Fire Physical |
|Occup|Insured is: | Owner/ Occupied | Owner/ Absentee landlord | Tenant | |
|ancy | | | | | |
| | |USE |Percent Used by |
| | | |Insured |
| |BASEMENT: | |- | % |
| |FIRST FLOOR: | |- | % |
| |SECOND FLOOR: | |- | % |
| |THIRD FLOOR: | |- | % |
| |FOURTH FLOOR: | |- | % |
| |OTHER: | |- | % |
| |Outbuildings or Appurtenant Structures? Non e | | |
| | |- | % |
|CONST| |
|RUCTI| |
|ON | |
| | |EXTERIOR |
| |Foundation: | Slab |Crawl Space | Basement | |
| |Exterior Walls: | Frame | Block | Brick | Other: | |
| |Roof: | Pitched: | Asphalt/ Composition | Other: | |
| | | Flat: | Rubberized | Tar & Gravel | Not Seen |
| |Age of Building: | |No. Stories: | | |
| | | | | | |
| |Overall Condition? | Good | Average | Improvement Needed |
| | |
| | |INTERIOR |
| |Ceiling: | Drywall | Plaster | Tin | Drop Tile | Other: |
| |Floors: | Carpet | Resilient | Hardwood |
| | |
| |Horizontal Cutoffs: |Exterior Doors |Exterior Windows |Interior Walls |
| | | Standard Doors | Stationary Windows | Firewall with Parapet |
| | | Self Closing Doors | Standard Windows | Block Wall/ Fire Partition – No Parapet |
| | | Fire Rated Doors | Skylights: _ | Fire Rated (Double) Sheet Rock |
| | | Other: | | | Standard Walls – Not Fire Rated |
| | |
| |Vertical Cutoffs: | None | Enclosed Stairwells w/ self closing doors | Open Stairwells | Dumb Waiter |
| | | Garbage Chute | Elevator | Other: | |
| | | | | |
| |Overall Condition? | Good | Average | Improvement Needed |
| | | | | |
| |Any Concealed Spaces? | None Noted | Above Drop Tile Ceiling | Attic |
| | | Soffits | Other: | |
| | |
| | PML (Probable Maximum Loss) = 100% |or PML = %- Less than100% - state why! |
| |REMARKS: |
| | |
|HEATI| |
|NG, | |
|ELECT| |
|RIC, | |
|PLUMB| |
|ING | |
| |Heating Fuel: | City Gas | | Electric Heat | Other: | |
| | | |Prop| | | |
| | | |ane | | | |
| | | |Gas | | | |
| |Heating Type: | BBHW | FHA | Steam | Other: |
| |Air Conditioning: | Central Unit | Central Unit - Roof | Window or Wall Units | None |
| |Furnace Location: | Ceiling Mounted | Basement | Vented Utility Room | Other: |
| |Furnace Condition: | Good | Average | Improvement Needed |
| | | | | | |
| | | Other: | | |
| |Overall Condition: | Good | Average | Improvement Needed |
| |Plumbing: | Copper % | PVC % | Galvanized % | Brass % |
| |Plumbing Condition: | Good | Average | Improvement Needed |
| |Sump Pump: | No | Yes - state why |
|PROTE| |
|CTON | |
| |Fire Station: | 0-1 mile | 1-3 miles | 3- 5 miles | none |
| |Fire Hydrant: | 0 - 500 feet | 500 - 1000 feet | > 1000 feet | None |
| |Other Water: |
| |Bldg. Sprinklered: | No | Yes- | Wet System |
| |Fire Alarms: | None | Automatic | Manual | Other |
| |Smoke Detectors: | None | Hardwired | Battery Operated | Other |
| | | |
| |Fire Extinguishers: |# | ABC |Dry Chem. |Tag Date: | None |
| | |
|EXPOS|Area: | Residential % | Mercantile % | Industrial % |
|URES | | | | |
| | | Urban | Suburban | Rural | |
| | |
| | |Distance |Construction |Use |
| | |Left | Ft | | | |
| | |Right | Ft | | | |
| | |Rear | Ft | | | |
| |Any Vacant Bldg. In Area | No | Yes | | |
| |Any Graffiti in Area? | No | Yes | | |
| |Any Other Noted Area Hazards? | No | Yes | | |
| |REMARKS | | |
| | |
Liability Physical
|Insured| |Use |
| | Absentee Landlord | |
| | Owner Occupied | |
| | Tenant: | |
| | |
|Buildin| |
|g Use | |
| | |Occupancy/ Area |
| | Habitational: | |
| | Industrial/ Warehouse | |
| | Retail – Open to the Public | |
| | Office: | |
| | |
|Habitat| |
|ional | |
| | None | |
| |Number of Families/ Apartments | |Remarks |
| |Two Means of Egress from Each Apartment? | Yes | No | |
| |Common Doors Kept Locked? | Yes | No | |
| |Hardwired Smoke Detectors in Common Areas? | Yes | No | |
| |Battery Smoke Detectors in Apartments? | Yes | No | |
| | | | | |
|EXTERIO| |u |s |
|R | | | |
| |Surfaces are Level |
| |Exterior Stairs | None |Ramps | None |
| |Uniform Tread & Rise w/i code |
| |Parking Lots | None |Dumpsters | None |
| |Smooth & Free of Potholes | | | | |
| |u = unsatisfactory |
|DIAGRAM| | Diagram Attached/ Unloaded |
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| | |Diagram Notes: |
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| | | |INSURED'S AREA | |
| | | | |Sq Feet | | |
| | | |Basement | | | |
| | | |1st Fl | | | |
| | | |2nd Fl | | | |
| | | |3rd Fl | | | |
| | | | |
|U/B = Unfinished Basement |C/C = Cathedral Ceiling |WBA = Wood Balcony |GBU = Built-in Garage |
|F/B = Finished Basement |OP = Open Porch |OB = Open Breezeway |BGF = Basement Garage |
|SLA = Slab on Ground |EP = Enclosed Porch |EB = Enclosed Breezeway |CPT = Carport |
|OS = Open Stairway |ES = Enclosed Stairway |F.E. = Fire Escape |E = Elevator |
|ADJ = Adjacent Structure |ATT = Attached Structure (Common Wall) |FW = Firewall w/ Parapet |
|Contents | Insured Is The Landlord And Does Not Occupy Space Here |
| | |Location/ Description/ Concentration |Est. Value |Peak Season Value |
| |Improvements & Betterments | |[pi| |[pi| |
| |Premises (Tenants Only) | |c] | |c] | |
| |Office Equipment/ Furniture | |[pi| |[pi| |
| | | |c] | |c] | |
| |Computers Electronics | |[pi| |[pi| |
| | | |c] | |c] | |
| |Machinery | |[pi| |[pi| |
| | | |c] | |c] | |
| |Stock – General Merchandise | |[pi| |[pi| |
| | | |c] | |c] | |
| |Stock – Perishable | |[pi| |[pi| |
| | | |c] | |c] | |
| |Target Stock? Describe | |[pi| |[pi| |
| | | |c] | |c] | |
| |Drugs or Medical Equipment | |[pi| |[pi| |
| | | |c] | |c] | |
| |Other: | |[pi| |[pi| |
| | | |c] | |c] | |
| |
|Burglary Protection | Insured Is the Landlord and Does Not Occupy Space Here |
| |Alarms | None | Insured did not wish to disclose |
| | | | | | |
| | |Rings at: | Central Station | Insured’s Home |
| | | | Police Department | Other: | | |
| | | | Local Gong | |
| | | | | | | |
| | |Activated by: | Perimeter system (tape or contacts on doors and windows) |
| | | | Motion Detectors (electron eyes) | | Video Monitored |
| | | | Heat Detectors or Infrared Detectors | | Other: | | |
| | | | | |
| | |Company that Installed System | | Not Avail or Not Known |
| | |Company Servicing this System | | Not Avail or Not Known |
| |
|Locks | | |
| | Doors: | Single Spring | | Single Dead | | Panic Bar |
| | | Double Spring | | Double Dead |
| | | Bars | | Other: | | |
| | Skylights: | Stationary | | Other: | | |
| | Other Openings: | | |
| | Fire Escapes | None | Accessible from the Ground | Not Readily Accessible |
| |
|Banking Practices | - Not Applicable |
| | | Daily | Weekly | Other: | |
| | | Cash | % | Checks | % | Other | % |
| |
| | |Any Cash taken home? | No | Yes |$ | | |
| | |Any Cash left overnight? | No | Yes |$ | | |
| |
|Area/ Neighborhood | |
| |Area: | Urban | Suburban | Rural |
| |
| |Crime Rate: |
| | |Considered: |
| | |Any Signs of Graffiti or VMM? | No | Yes – describe or photo |
| | |Vacant or Boarded Bldg. in the Area? | No | Yes – describe or photo |
| | |Police Patrol Area? | No | Yes - | Foot Patrol | Bike Patrol | Squad Car |
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