Vacant land General Liability Quote Vacant land General Liability QuoteName *Email *Phone *PRINCIPALS (if in a company name) Mailing Address Street AddressApt, Suite, Bldg. (optional)CityState / Province / RegionPostal / Zip CodeAfghanistanAlbaniaAlgeriaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCentral African RepublicChadChileChinaColombiaComorosCongo (Brazzaville)CongoCosta RicaCote d\'IvoireCroatiaCubaCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast Timor (Timor Timur)EcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFijiFinlandFranceGabonGambia, TheGeorgiaGermanyGhanaGreeceGrenadaGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiKorea, NorthKorea, SouthKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorwayOmanPakistanPalestinian TerritoryPalauPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint VincentSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSudanSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited States of AmericaUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamWestern SaharaWestern SamoaYemenZambiaZimbabweCountryLAND DETAILS:Legal description of land-location: Is the property fully fenced? YesNoAre there any signs posted (i.e. private property) YesNoAre there any hazards (water) or attractive nuisances? (i.e. ponds, lakes, pits, quarries, machinery, open minds, playground equipment etc.) YesNoIf above answer-yes -then Explain : VACANCYHow long has the property been vacant? Why the property has been vacant? What is the anticipated future of this land? What will be the approximate duration of vacancy? How often is the property being checked? Is the property being maintained in a usable and salable condition at all times? YesNoIs there any public use of the land permitted (i.e. cross Country skiing, hunting, snowmobile trails, horseback, off road, swimming)? BUILDING DETAILS:Are there any buildings on the property? YesNoIf above yes and Age of Building: Openings covered/boarded? YesNoDoes property have fire extinguishers? YesNoOperable smoke detectors? YesNoAlarm system? YesNoWhat means have been taken to prevent building from looking unoccupied? POLLUTION EXPOSURES:Does the land, or has it ever, contained an above or underground tank(s)? YesNoIs the land deemed to be contaminated? YesNoSCHEDULE:Please list properties to be insured. Address and Description Previous Insurance:Type of insurance? Previous insurance company, Policy #: Is renewal being offered? YesNoIf no, please explain Loss history (date; paid/estimated amount; cause; open/closed)? Limits Required:General Liability: Deductible Requested: Comments: The completion of this form is for quote purpose and does not provide any insurance coverage. We may require more information in order to provide a quote. This quote request contains some information about coverage offered but it does not contain all. VerificationPlease enter any two digits *Example: 12This box is for spam protection - please leave it blank:
Vacant land General Liability Quote Vacant land General Liability QuoteName *Email *Phone *PRINCIPALS (if in a company name) Mailing Address Street AddressApt, Suite, Bldg. (optional)CityState / Province / RegionPostal / Zip CodeAfghanistanAlbaniaAlgeriaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCentral African RepublicChadChileChinaColombiaComorosCongo (Brazzaville)CongoCosta RicaCote d\'IvoireCroatiaCubaCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast Timor (Timor Timur)EcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFijiFinlandFranceGabonGambia, TheGeorgiaGermanyGhanaGreeceGrenadaGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiKorea, NorthKorea, SouthKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorwayOmanPakistanPalestinian TerritoryPalauPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint VincentSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSudanSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited States of AmericaUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamWestern SaharaWestern SamoaYemenZambiaZimbabweCountryLAND DETAILS:Legal description of land-location: Is the property fully fenced? YesNoAre there any signs posted (i.e. private property) YesNoAre there any hazards (water) or attractive nuisances? (i.e. ponds, lakes, pits, quarries, machinery, open minds, playground equipment etc.) YesNoIf above answer-yes -then Explain : VACANCYHow long has the property been vacant? Why the property has been vacant? What is the anticipated future of this land? What will be the approximate duration of vacancy? How often is the property being checked? Is the property being maintained in a usable and salable condition at all times? YesNoIs there any public use of the land permitted (i.e. cross Country skiing, hunting, snowmobile trails, horseback, off road, swimming)? BUILDING DETAILS:Are there any buildings on the property? YesNoIf above yes and Age of Building: Openings covered/boarded? YesNoDoes property have fire extinguishers? YesNoOperable smoke detectors? YesNoAlarm system? YesNoWhat means have been taken to prevent building from looking unoccupied? POLLUTION EXPOSURES:Does the land, or has it ever, contained an above or underground tank(s)? YesNoIs the land deemed to be contaminated? YesNoSCHEDULE:Please list properties to be insured. Address and Description Previous Insurance:Type of insurance? Previous insurance company, Policy #: Is renewal being offered? YesNoIf no, please explain Loss history (date; paid/estimated amount; cause; open/closed)? Limits Required:General Liability: Deductible Requested: Comments: The completion of this form is for quote purpose and does not provide any insurance coverage. We may require more information in order to provide a quote. This quote request contains some information about coverage offered but it does not contain all. VerificationPlease enter any two digits *Example: 12This box is for spam protection - please leave it blank: