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Commercial Property Profile (COPE) - Single Building Form
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What is your first name?*
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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?*
Please select the situation that is dictating the need for this information.
Please select the situation that is dictating the need for this information.
Adding a building
Deleting a building
Remodeling a building
Revaluation of a building
Other
Please provide a brief description of the situation dictating the need for this information.
Please provide a brief description of the situation dictating the need for this information.
Do you own or lease the building?
Do you own or lease the building?
Own
Lease
What is the legal name of the owner of the building?*
*
What is the legal name of the owner of the building?*
What is the address of the building for which you are providing information?*
*
What is the address of the building for which you are providing information?*
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 Code
Construction
Please select this building's construction type.
Please select the building's construction type.
A - Fireproof Steel Frame
B - Reinforced Concrete/Non-Combustible
C - Masonry Construction/Wood Roof
D - All Combustible (Wood Frame)
S - Pre-engineered/Steel
U - Unknown
Please select the term that best describes the condition of the building.
Please select the term that best describes the condition of the building.
Excellent
Very Good
Good
Average
Fair
Poor
Please select the term that best describes the quality of the building.
Please select the term that best describes the quality of the building.
Excellent
Good
Average
Low
What construction material was used for the walls?
What construction material was used for the walls?
Brick
Poured Concrete
Brick Veneer
Frame
Hollow Block (Brick Faced)
Metal Clad
All Metal
How old is the heating system?
How old is the heating system?
What type of heating system does the building have?
What type of heating system does the building have?
Forced Air
Window Unit
Wall Unit
How old is the cooling system?
How old is the cooling system?
What type of cooling system does the building have?
What type of cooling system does the building have?
Forced Air
Window Unit
Wall Unit
What type of fuel does the heating/AC system utilize?
What type of fuel does the heating/AC system utilize?
Electric
Gas
Oil
Diesel
Solar
Does the building have a basement?
Does the building have a basement?
Yes
No
Does the building have an attic/penthouse?
Does the building have an attic/penthouse?
Yes
No
What year was the building built?
What year was the building built?
Has the building been renovated since its was built?
Has the building been renovated since its was built?
Yes
No
Not sure
What year was the building renovated?
What year was the building renovated?
What is the floor height? (In feet)
What is the floor height? (In feet)
How many floors/stories does the building have?
How many floors/stories does the building have?
What is the total square footage of the building?
What is the total square footage of the building?
What is the value of the building?
What is the value of the building?
What is the value of the contents within the building?
What is the value of the contents within the building?
Occupancy Classification
Is the building vacant?
Is the building vacant?
Yes
No
What is the occupancy classification of the building?
What is the occupancy classification of the building?
Airport
Armory
Assembly
Community Center
Educational
Fire Station
Gymnasium
Hospital
Industrial
Jail/Detention
Library
Mercantile
Office
Park Garage
Parks & Recreation
Public Building
Public Safety
Residence
School
Shop
Warehouse
Piers
Bulkheads
Boardwalk
Docks
Bridges
Other
Please provide a description of the occupancy of the building.
Please provide a description of the occupancy of the building.
Protection Features
Is the building equipped with fire extinguishers?
Is the building equipped with fire extinguishers?
Yes
No
Is the building's inspection current?
Is the building's inspection current?
Yes
No
Does the building have a manual pull box fire alarm system?
Does the building have a manual pull box fire alarm system?
Yes
No
Is the manual pull box fire alarm being monitored/supervised?
Is the manual pull box fire alarm being monitored/supervised?
Yes
No
Does the building have sprinkler protection?
Does the building have sprinkler protection?
Yes
No
What percentage of the building is sprinklered?
What percentage of the building is sprinklered?
Is the sprinkler system being monitored/supervised?
Is the sprinkler system being monitored/supervised?
Yes
No
Does the building have smoke/heat detectors?
Does the building have smoke/heat detectors?
Yes
No
Are the smoke/heat detectors being monitored/supervised?
Are the smoke/heat detectors being monitored/supervised?
Yes
No
Does the building have a security system?
Does the building have a security system?
Yes
No
Is the security system being monitored/supervised?
Is the security system being monitored/supervised?
Yes
No
Does the building have fire hydrants within 1,001 feet?
Does the building have fire hydrants within 1,001 feet?
Yes
No
Does the building have a fire department within five miles?
Does the building have a fire department within five miles?
Yes
No
Exposures
Is the building located in a severe hazard flood zone? (I.e. A, V, etc.)
Is the building located in a severe hazard flood zone? (I.e. A, V, etc.)
Yes
No
Is the building located in a high wind prone area? (I.e. coastal)
Is the building located in a high wind prone area? (I.e. coastal)
Yes
No
Does the building have any special hazards that could impact it? (I.e. Earthquake, etc.)
Does the building have any special hazards that could impact it? (I.e. Earthquake, etc.)
Yes
No
Please provide a brief description of the special hazards that could impact this building.
Please provide a brief description of the special hazards that could impact this building.
Please select the term that best describes this building's exposure to risk of physical damage.
Please select the term that best describes this building's exposure to risk of physical damage.
Low
Moderate
Severe
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.
<font size="2" color="gray">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.
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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*
AJG (Ericson) Service
860-868-7361
www.ericsoninsurance.com
GGB.WashingtonDepot.Service@ajg.com
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