NOTE: Completion of application does not constitute a binding of coverage. Applications will be reviewed and rated with a formal proposal and invoice to follow.

 

Please email rmf@sigmachi.org with questions. 

 

 


 

Property Address Information
House Corporation Info
Billing Contact Info
Enter full address including city / state / zip code information
MORTAGE/LOSS PAYEE INFORMATION
Enter full address including city / state / zip code information
FACILITY INSPECTION CONTACT
BUILDING INFORMATION
* Separate information is required for each building.
Please provide what year each of the following was last replaced / updated / renovated:
TYPE OF FIRE PROTECTION SYSTEMS
Square Footage
ANY UNUSUAL HAZARDS NEARBY?
Heating / Cooling
SPRINKLER SYSTEM
If yes, answer the following questions:
If yes, please complete the contractor's contact information below.
Enter full address including city / state / zip code information
Current Coverage Information
APPLICATION WARRANTY AND INSTRUCTIONS

I hereby warrant and confirm that the above information, to the best of my knowledge, is true and correct, and further certify that I have read all of the questions and answers of this application. I understand this application is a requirement for coverage and evidence of my acceptance of this insurance, and any falsification or misrepresentation will be deemed a breach of contract, voiding all insurance coverage. It is understood and agreed that the completion of this application shall not be binding either to the proposed insured or the company until accepted by the company or companies in writing from James R. Favor & Company, LLC.

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