Piedmont Consulting LLC - NREIG Main Proposal Request

Property #1

Property Address to be Insured*

Address Line 1

Address Line 2

City

State

ZIP Code

Property Type*

Will this location be used as a Vacation Rental?*

Yes No

How much coverage would you like for contents?*

i.e., furnishings such as curtains, furniture, stereo, tv, computer equipment, etc

Construction Type*

Block Brick Frame Metal Modular/Mobile

Year Built*

If unknown enter closest approximation

Square Footage*

If unknown enter closest approximation

Number of Stories*

Number of Units*

Is there a pool, spa, or hot tub at this location?*

Yes No

Does the pool, spa, or hot tub meet current municipal code?*

Yes No

Does the association maintain the pool, spa, or hot tub?*

Yes No

Does the association maintain the pool, spa, or hot tub?*

Yes No

UPDATES

Please provide approximate year of last update. If unknown the year built will be used.

Roof*

Electric*

Plumbing*

HVAC*

Is (either) Knob-and-Tube or Aluminum Wiring present?*

No Yes, Aluminum Yes, Knob-and-Tube Unknown

Has the Aluminum Wiring been remediated?*

Yes No

All forms of remediation are acceptable: Co/ALR, Pigtail and AlumniCon.

Occupancy Status*

Rental dwelling - Occupied (including condos) Renovation - Currently undergoing rehab (or within 30 days after acquisition) Vacant - Not undergoing renovation Force Placed - Vacant Force Placed - Occupied

What is the total % of occupancy?*

Are there any structural issues present?*

Yes No

Foundation, roof, or load bearing walls for example.

Is the porch or roofline sagging?*

Yes No

What is your intent for the property over the next 60 days?*

Is the location being monitored, boarded and/or secured?*

Yes No

Renters Insurance Requirement*

Yes No

For occupied locations, I require, enforce, and document, that tenants carry renters insurance.

What is your purchase price?*

What is your expected renovation cost?*

Projected Total* $

Factored for underwriting purposes only

Would you like coverage for Earth Movement?*

Yes No

Protection for Sinkhole and Earthquake Shock perils. Coverage is not available in: AK, CA, FL, HI, or IL

Other Considerations*

Other Considerations
	Yes	No
Does the property have any common areas?	Other Considerations: Does the property have any common areas? (Yes)	Does the property have any common areas? (No)
Are functioning smoke detectors installed?	Are functioning smoke detectors installed? (Yes)	Are functioning smoke detectors installed? (No)
Does any commercial cooking occur on the premises?	Does any commercial cooking occur on the premises? (Yes)	Does any commercial cooking occur on the premises? (No)
Does the attached parking available exceed 2,000 square feet or 24 spaces?	Does the attached parking available exceed 2,000 square feet or 24 spaces? (Yes)	Does the attached parking available exceed 2,000 square feet or 24 spaces? (No)

Common Areas are any available for use by more than one tenant.

Rental Assistance*

What % of your tenants (if any) are subsidized?

Acres*

Is this location professionally managed?*

Yes No

Who monitors the property, how often? *

Property Manager's Name*

If your business address exceeds 150 miles from the property, your property manager's address must be provided.

Property Manager's Address*

Address Line 1

Address Line 2

City

State

ZIP Code

Property Manager's Phone*

Is there a Mortgagee or Third Party Lender?*

Yes No

Loan Number?

Mortgagee - Third Party Options*

Private lender Partner Traditional Lender/Bank Lease-option or Land contract

Other:

Mortgagee or 3rd Party Name*

Mortgagee or 3rd Party Address*

Address Line 1

Address Line 2

City

State

ZIP Code

Mortgagee or 3rd Party Phone

If available

Mortgagee or 3rd Party Phone Fax

If available

Mortgagee or 3rd Party Email

If available

Is the insurance for this location paid through an escrow account?*

Yes No

Does the mortgagee/escrow account need to be billed for this location?

Are there any additional parties that need to be listed?*

ie. 2nd Mortgage Holder

Coverage Amount Requested (Please Enter "0" for Liability Only)* $

Replacement Cost (RC) and Actual Cash Value (ACV) are coverage options that differ in how a covered loss settlement will be calculated. RC settles claims with the ability to recoup depreciation, whereas ACV does not. Though ACV may be less expensive than RC due to lower insured values, remember, that settlement is subject to non-recoverable DEPRECIATION. Most Program policies offer coverage without a co-insurance requirement if the insured value is above $50 per square foot. With most of our Program policies, RC is garnered by insuring the location to at least $70 per square foot. Locations with insured values below $50 per square foot are subject to an 80% co-insurance requirement. Please contact us to discuss your coverage specifics.

Loss of Rents Amount Requested* $

If this coverage is desired, enter the monthly rent amount. If not applicable enter, "0".

Desired Deductible*

$2,500 $5,000 $10,000+ Need Help Deciding

What deductible would you like?

Are there any other structures on the property?*

Yes No

i.e., detached garage, shed, etc.

Do you wish to insure this structure from property damage?*

Yes No

'Other Structures' Amount Requested* $

Enter the requested amount of coverage for other structures like a detached garage. If not applicable, enter "0".

Property #2

Property Address to be Insured*

Address Line 1

Address Line 2

City

State

ZIP Code

Property Type*

Will this location be used as a Vacation Rental?*

Yes No

How much coverage would you like for contents?*

i.e., furnishings such as curtains, furniture, stereo, tv, computer equipment, etc

Construction Type*

Block Brick Frame Metal Modular/Mobile

Year Built*

If unknown enter closest approximation

Square Footage*

If unknown enter closest approximation

Number of Stories*

Number of Units*

Is there a pool, spa, or hot tub at this location?*

Yes No

Does the pool, spa, or hot tub meet current municipal code?*

Yes No

Does the association maintain the pool, spa, or hot tub?*

Yes No

Does the association maintain the pool, spa, or hot tub?*

Yes No

UPDATES

Please provide approximate year of last update. If unknown the year built will be used.

Roof*

Electric*

Plumbing*

HVAC*

Is (either) Knob-and-Tube or Aluminum Wiring present?*

No Yes, Aluminum Yes, Knob-and-Tube Unknown

Has the Aluminum Wiring been remediated?*

Yes No

All forms of remediation are acceptable: Co/ALR, Pigtail and AlumniCon.

Occupancy Status*

What is the total % of occupancy?*

Are there any structural issues present?*

Yes No

Foundation, roof, or load bearing walls for example.

Is the porch or roofline sagging?*

Yes No

What is your intent for the property over the next 60 days?*

Is the location being monitored, boarded and/or secured?*

Yes No

Renters Insurance Requirement*

Yes No

For occupied locations, I require, enforce, and document, that tenants carry renters insurance.

What is your purchase price?*

What is your expected renovation cost?*

Projected Total* $

Factored for underwriting purposes only

Would you like coverage for Earth Movement?*

Yes No

Protection for Sinkhole and Earthquake Shock perils. Coverage is not available in: AK, CA, FL, HI, or IL

Other Considerations*

Other Considerations
	Yes	No
Does the property have any common areas?	Other Considerations: Does the property have any common areas? (Yes)	Does the property have any common areas? (No)
Are functioning smoke detectors installed?	Are functioning smoke detectors installed? (Yes)	Are functioning smoke detectors installed? (No)
Does any commercial cooking occur on the premises?	Does any commercial cooking occur on the premises? (Yes)	Does any commercial cooking occur on the premises? (No)
Does the attached parking available exceed 2,000 square feet or 24 spaces?	Does the attached parking available exceed 2,000 square feet or 24 spaces? (Yes)	Does the attached parking available exceed 2,000 square feet or 24 spaces? (No)

Common Areas are any available for use by more than one tenant.

Rental Assistance*

What % of your tenants (if any) are subsidized?

Acres*

Is this location professionally managed?*

Yes No

Who monitors the property, how often? *

Property Manager's Name*

If your business address exceeds 150 miles from the property, your property manager's address must be provided.

Property Manager's Address*

Address Line 1

Address Line 2

City

State

ZIP Code

Property Manager's Phone*

Is there a Mortgagee or Third Party Lender?*

Yes No

Loan Number?

Mortgagee - Third Party Options*

Private lender Partner Traditional Lender/Bank Lease-option or Land contract

Other:

Mortgagee or 3rd Party Name*

Mortgagee or 3rd Party Address*

Address Line 1

Address Line 2

City

State

ZIP Code

Mortgagee or 3rd Party Phone

If available

Mortgagee or 3rd Party Phone Fax

If available

Mortgagee or 3rd Party Email

If available

Is the insurance for this location paid through an escrow account?*

Yes No

Does the mortgagee/escrow account need to be billed for this location?

Are there any additional parties that need to be listed?*

ie. 2nd Mortgage Holder

Coverage Amount Requested (Please Enter "0" for Liability Only)* $

Loss of Rents Amount Requested* $

If this coverage is desired, enter the monthly rent amount. If not applicable enter, "0".

Desired Deductible*

$2,500 $5,000 $10,000+ Need Help Deciding

What deductible would you like?

Are there any other structures on the property?*

Yes No

i.e., detached garage, shed, etc.

Do you wish to insure this structure from property damage?*

Yes No

'Other Structures' Amount Requested* $

Enter the requested amount of coverage for other structures like a detached garage. If not applicable, enter "0".

Property #3

Property Address to be Insured*

Address Line 1

Address Line 2

City

State

ZIP Code

Property Type*

Will this location be used as a Vacation Rental?*

Yes No

How much coverage would you like for contents?*

i.e., furnishings such as curtains, furniture, stereo, tv, computer equipment, etc

Construction Type*

Block Brick Frame Metal Modular/Mobile

Year Built*

If unknown enter closest approximation

Square Footage*

If unknown enter closest approximation

Number of Stories*

Number of Units*

Is there a pool, spa, or hot tub at this location?*

Yes No

Does the pool, spa, or hot tub meet current municipal code?*

Yes No

Does the association maintain the pool, spa, or hot tub?*

Yes No

Does the association maintain the pool, spa, or hot tub?*

Yes No

UPDATES

Please provide approximate year of last update. If unknown the year built will be used.

Roof*

Electric*

Plumbing*

HVAC*

Is (either) Knob-and-Tube or Aluminum Wiring present?*

No Yes, Aluminum Yes, Knob-and-Tube Unknown

Has the Aluminum Wiring been remediated?*

Yes No

All forms of remediation are acceptable: Co/ALR, Pigtail and AlumniCon.

Occupancy Status*

What is the total % of occupancy?*

Are there any structural issues present?*

Yes No

Foundation, roof, or load bearing walls for example.

Is the porch or roofline sagging?*

Yes No

What is your intent for the property over the next 60 days?*

Is the location being monitored, boarded and/or secured?*

Yes No

Renters Insurance Requirement*

Yes No

For occupied locations, I require, enforce, and document, that tenants carry renters insurance.

What is your purchase price?*

What is your expected renovation cost?*

Projected Total* $

Factored for underwriting purposes only

Would you like coverage for Earth Movement?*

Yes No

Protection for Sinkhole and Earthquake Shock perils. Coverage is not available in: AK, CA, FL, HI, or IL

Other Considerations*

Other Considerations
	Yes	No
Does the property have any common areas?	Other Considerations: Does the property have any common areas? (Yes)	Does the property have any common areas? (No)
Are functioning smoke detectors installed?	Are functioning smoke detectors installed? (Yes)	Are functioning smoke detectors installed? (No)
Does any commercial cooking occur on the premises?	Does any commercial cooking occur on the premises? (Yes)	Does any commercial cooking occur on the premises? (No)
Does the attached parking available exceed 2,000 square feet or 24 spaces?	Does the attached parking available exceed 2,000 square feet or 24 spaces? (Yes)	Does the attached parking available exceed 2,000 square feet or 24 spaces? (No)

Common Areas are any available for use by more than one tenant.

Rental Assistance*

What % of your tenants (if any) are subsidized?

Acres*

Is this location professionally managed?*

Yes No

Who monitors the property, how often? *

Property Manager's Name*

If your business address exceeds 150 miles from the property, your property manager's address must be provided.

Property Manager's Address*

Address Line 1

Address Line 2

City

State

ZIP Code

Property Manager's Phone*

Is there a Mortgagee or Third Party Lender?*

Yes No

Loan Number?

Mortgagee - Third Party Options*

Private lender Partner Traditional Lender/Bank Lease-option or Land contract

Other:

Mortgagee or 3rd Party Name*

Mortgagee or 3rd Party Address*

Address Line 1

Address Line 2

City

State

ZIP Code

Mortgagee or 3rd Party Phone

If available

Mortgagee or 3rd Party Phone Fax

If available

Mortgagee or 3rd Party Email

If available

Is the insurance for this location paid through an escrow account?*

Yes No

Does the mortgagee/escrow account need to be billed for this location?

Are there any additional parties that need to be listed?*

ie. 2nd Mortgage Holder

Coverage Amount Requested (Please Enter "0" for Liability Only)* $

Loss of Rents Amount Requested* $

If this coverage is desired, enter the monthly rent amount. If not applicable enter, "0".

Desired Deductible*

$2,500 $5,000 $10,000+ Need Help Deciding

What deductible would you like?

Are there any other structures on the property?*

Yes No

i.e., detached garage, shed, etc.

Do you wish to insure this structure from property damage?*

Yes No

'Other Structures' Amount Requested* $

Enter the requested amount of coverage for other structures like a detached garage. If not applicable, enter "0".

Property Information

If you have a spreadsheet of properties or current declarations pages, please upload below. You may only upload up to 25 MB of data per form submission. If your files exceed the limit, please email your property information to info@nreig.com.
Please give us a call at 888-741-8454 if you have any questions.

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Additional Information

Have you had any claims in the last 5 years?*

Yes No

Type of Loss*

Claims information is required for underwriting purposes

Date of Loss*

Loss Amount*

Please describe any losses or damage not reported to an Insurance Carrier within the past 5 years.*

Anything else you would like to tell us?

Please add any notes here or indicate details for any imminent closing.

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PROPOSAL REQUEST

Property #1

Property #2

Property #3

Property Information

Additional Information