HOTELS BLOCK

INSURANCE QUESTIONNAIRE

From:
Quotation needed by:
Coverage Effective date:

Hotel Name:
Contact Name:

Address:



Hotel Brand:




Facilities :		How Many?
	Guest Rooms		Number of Buildings
	Restaurants		Number of Floors
	Bar/Lounges
	Conference Rooms
	Parking Facilities:
	Self Parking:
	Valet Parking:
	# of Parking Spaces

	Hotel Revenues:	US$
Annual Hotel	Restaurant Revenues:	US$
Reveues:	Other Revenues:	US$
	Liquor Revenues:	US$

PROPERTY/CASUALTY INSURANCE EXPOSURE INFORMATION:

Insured Values:

Buildings:

US$

(If material damage cover is desired)

Contents:

US$

Business Interruption:

24 Months Gross Profit:

US$

(Include all values for computer equipment, fine arts, antiques, boiler & machinery or any other furnishings or equipment)

Loss History:

Date

Description

Open/Closed

Paid

Please attach detailed information for losses greater than $25,000)

Fire Protection:

Type:

Service

Areas

Guest

Rooms

Public

Areas

Garages

Sprinklers

100%

N/A

Automatic Fire Detectors

100%

N/A

Manual

Fire Alarms

100%

N/A

Property Data:

1.)

When was the hotel built?

2.)

What is the total square footage of the hotel?

3.)

What is the distance from:

Sea

River

-------

Flood Plain

---------

4.)

What is the hotel construction type?

5.)

Please attach a site plan and/or brochure of the property.

6.)

If a resort property, describe all activities offered:

Safety:	Fire alarm system:	YES
	Emergency Generator:		Yes		No
	Booster Fire Pump:		Yes		No
	Other: (i.e. voice evacuation system, etc.):					COPMLETE VOICE EVACUATION
	Are all emergency exits properly marked?						Yes	No
	Emergency exits per floor:			YES

Annual Hotel

Date

Description

Open/Closed

Paid