Features
Plans & Pricing
About
Login
Sign Up
Collector Car Storage Facility Form
Share
What is your first name? *
*
What is your first name? *
What is your last name? *
*
What is your last name? *
What is your email address? *
*
What is your email address? *
What is your phone number? *
*
What is your phone number? *
General Information
Physical Address
What is the physical address of the storage facility?
Street Address
Address Line 2
City
State
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
Zip
Year Constructed
What year was the building constructed?
Square Feet
What is the square footage of the building?
How many vehicles do you have stored as this location?
How many vehicles do you have stored as this location?
What is the number of vehicles this facility can safely store?
What is the number of vehicles this facility can safely store?
What is the total value of vehicles at this location?
What is the total value of vehicles at this location?
How long have your vehicles been garaged at this location?
How long have your vehicles been garaged at this location?
Is this building/location owned or leased?
Is this building/location owned or leased?
Owned
Leased
Is this building/location commercial or residential?
Is this building/location commercial or residential?
Commercial
Residential
Is the building a multi-tenant building?
Is the building a multi-tenant building?
Yes
No
Please explain.
Please explain.
Is there any restoration work being done on the premises?
Is there any restoration work being done on the premises?
Yes
No
Please explain.
Please explain.
Security Protection
What security protections are in place at this building/location? (Check all that apply)
What security protections are in place at this building/location? (Check all that apply)
Central Station Burglar Alarm (monitored outside facility)
Local Burglar Alarm (only on premises)
No Burglar Alarm
Surveillance Cameras
24 Hour On-Premise Security
Padlocks or Deadbolts
Fenced/Gated Property
Watchdog on Premises
Other
What is the name of the central station monitoring company?
What is the name of the central station monitoring company?
What other security protections are in place at this facility?
What other security protections are in place at this facility?
Building Construction
Select the construction material used for the walls.
Select the construction material used for the walls.
Wood Frame
Steel Frame
Masonry
Select the construction material used for the roof.
Select the construction material used for the roof.
Wood Frame
Steel Frame
Masonry
Select the construction material used for the floors.
Select the construction material used for the floors.
Concrete
Wood
Tile
Select the type(s) of climate control at this facility.
Select the type(s) of climate control at this facility.
Heat
Air Conditioning
How many stories does this facility have?
How many stories does this facility have?
Fire Protection
What type of fire alarm does the facility have?
What type of fire alarm does the facility have?
Central Station (monitored outside facility)
Local Alarm (alarm sounds only on premises)
No Alarm
What is the name of the central station monitoring company for the fire alarm?
What is the name of the central station monitoring company for the fire alarm?
What other types of fire protections does this facility have in place?
What other types of fire protections does this facility have in place?
Fire Extinguishers
Sprinkler System
No Fire Alarm
Other
What is the sprinkler system inspection date?
What is the sprinkler system inspection date?
MM slash DD slash YYYY
What other type(s) of fire protection does this facility have in place?
What other type(s) of fire protection does this facility have in place?
Flood/Hurricane Exposure
(For vehicles stored in FL, GA, MS, LA, SC, TX, NC, VA, DE, NJ, NY, CT, RI, ME, AL, HI, or MD)
Is this storage facility subterranean or below grade?
Is this storage facility subterranean or below grade?
Yes
No
Does the facility have a pumping system that is attached to a backup generator?
Does the facility have a pumping system that is attached to a backup generator?
Yes
No
Is there a drainage system installed at this location?
Is there a drainage system installed at this location?
Yes
No
How far is this facility from the coast? (Miles)
How far is this facility from the coast? (Miles)
Has the storage location ever had any flood or wind retrofitting?
Has the storage location ever had any flood or wind retrofitting?
Yes
No
Please describe.
Please describe.
What year was the flood and/or wind retrofitting completed?
What year was the flood and/or wind retrofitting completed?
Have you ever had any flood-related claims on the building or contents?
Have you ever had any flood-related claims on the building or contents?
Yes
No
Please describe.
Please describe.
Is there a hurricane evacuation plan in place for the vehicles?
Is there a hurricane evacuation plan in place for the vehicles?
Yes
No
How would vehicles be moved in an evacuation?
How would vehicles be moved in an evacuation?
Trailered
Self-Driven
What address would the vehicles be moved to?
What address would the vehicles be moved to?
Street Address
City
State
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
Zip
Provide a description of this address and its safety/security features.
Provide a description of this address and its safety/security features.
Earthquake Exposure
(For vehicles stored in CA, NV, OR, AZ, IL, KY, MO, IN, AR, AK, HI, or WA)
Has the storage location ever had any retrofitting or other wall bracing?
Has the storage location ever had any retrofitting or other wall bracing?
Yes
No
Please describe.
Please describe.
What year was the retrofitting or other wall bracing completed?
What year was the retrofitting or other wall bracing completed?
Have you ever had any earthquake-related claims on the building or its contents?
Have you ever had any earthquake-related claims on the building or its contents?
Yes
No
Please describe.
Please describe.
Documents and Comments
Please use this field to upload any relevant insurance documents.
Please use this field to upload any relevant insurance documents.
Drop files here or
Select files
Max. file size: 128 MB, Max. files: 10.
Please enter any additional remarks in the space below.
Please enter any additional remarks in the space below.
How did you hear about us?
How did you hear about us?
Current customer
Referred by...
Google search
Agency's website
Email newsletter
Facebook
Instagram
Twitter
Other
Please share who referred you to us.
Please share who referred you to us.
Please share what you typed into Google.
Please share what you typed into Google.
Please share how you heard about us.
Please share how you heard about us.
Disclaimer: This online questionnaire is a tool used to gather information. It is not an application for insurance. No insurance coverage will be bound or put into effect by submitting this form. Consumer disclosure: By checking the box below you authorize the Agency who supplied this form to you to contact you via phone, email, and text messaging; to save and share with business partners the information you provided; to obtain consumer reports that may include credit-based reports (where legally allowed), public records, claims history, and driving records so that they can give you accurate insurance quotes. *
*
Disclaimer: This online questionnaire is a tool used to gather information. It is not an application for insurance. No insurance coverage will be bound or put into effect by submitting this form.
Consumer disclosure: By checking the box below you authorize the Agency who supplied this form to you to contact you via phone, email, and text messaging; to save and share with business partners the information you provided; to obtain consumer reports that may include credit-based reports (where legally allowed), public records, claims history, and driving records so that they can give you accurate insurance quotes. *
I agree*
Annie Video
203-313-1781
www.google.com
annievideo18@gmail.com
Annie Video
Hi
Back to Profile
Share
Share This
×
Share this page using the link below:
Copy Link
Link copied!