Instructions: Please complete for each park for special preferred consideration.
Insured ______
Policy Number ______Effective Date ______Location ______Year Constructed ______
1.This park consists of two or more buildings at a single location, constructed in the last 25 years, and
located in protection classes 1 through 6. (If condo association all buildings are included) [ ] Yes[ ] No
2. Industrial buildings are no more than 3 stories in height and not frame construction?[ ] Yes[ ] No
3. Office buildings are no more than 7stories in height and protected with an automatic sprinkler system
if over 5 stories.[ ] Yes[ ] No
4.Office buildings have no more than 20% of rentable space occupied for retail stores or restaurants?
(deli’s without cooking are excepted) [ ] Yes [ ] No
5. The occupancies and floor areas of each industrial building are included with the submission?
(must have for consideration)[ ] Yes[ ] No
6. A diagram of the complex with distances between buildings is included with the submission?
(must have for consideration)[ ] Yes[ ] No
7. Leases include a hold harmless agreement in favor of landlord?[ ] Yes[ ] No
8. Certificates of insurance including additional insured endorsements in favor of landlord are obtained
from each tenant and maintained by manager or insured?[ ] Yes[ ] No
9. Vacancy factor does not exceed 25% or signed leases are in place with 75% occupancy guaranteed
within 30 days[ ] Yes[ ] No
- Walkways, streets, parking areas, loading docks are free of trip-and-fall hazards and are well lighted? [ ] Yes [ ] No
- Underground parking garages are adequately ventilated and equipped with an automatic sprinkler system? (unless exempted by local building code) [ ] Yes [ ] No
- Elevators are routinely inspected and maintained in accordance with manufacturer’s recommendations.
[ ] Yes[ ] No
- All structures are well maintained and easily accessible with no un-repaired damage?[ ] Yes[ ] No
- Industrial parks with more than 30% of the total rentable area occupied with occupancies rated hazard grade 7or higher may not be included for underwriting under these deviations unless the hazard is well controlled as evidenced by a Risk Control survey. Hazards are well controlled. [ ] Yes [ ] No
- Restaurants or shops with grills or deep fat fryers are equipped with an auto fire suppressant system with automatic fuel cutoff protecting all cooking areas and serviced on at least a semiannual basis by a licensed contractor. An outside flue-cleaning service is required .for hoods and ducts on at least a quarterly basis. [ ] Yes [ ] No
>Please Provide Two Typical Photos For Full Pricing Consideration>
Completed by ______Date ______ECU112 (05/01 Rev) DRAFT