Gallagher Test Form v2.0

Will the home be unoccupied more than 30 days? *

Have any renovations been done previously? *

Are you willing/planning to install an alarm system? *

Are there any detached structures on the property? *

Is this a condominium or cooperative? *

Are you in the process of purchasing this condominium/cooperative? *

Do you have an elevation certificate? *

Is the home built over water? *

Has this home had any prior flood losses? *

Is there machinery that services this residence in the basement? (I.e. Central air conditioner, furnace, hot water heater, heat pump, elevator machinery and equipment.) *

What is the approximate value of the machinery that services the building? *

Are there any washers/dryers/food freezers located in the basement? *

What is the approximate value of the washers/dryers/food freezers located in the basement? *

Is there at least 100 feet of brush clearance surrounding the residence? (Brush vegetation is a general term for woody plants, such as shrubs and small trees, that grow thickly together.) *

Is there a permanent resident or caretaker living on the premises? *

Will the home be unoccupied more than 30 days? *

Have any renovations been done previously? *

Are you willing/planning to install an alarm system? *

Is this home listed on the National Register of Historic Homes or in a historic district? *

Is there a fire hydrant within 1,000 feet of your home? *

Does this home have radiant flooring? *

Was the electrical update partial or complete? *

Select the type of electrical system. *

Was the plumbing update partial or complete? *

Are there any known leaks? *

Was the heating update partial or complete? *

Is there an attic? *

Is the attic unfinished, partially finished, or fully finished? *

Are there any detached structures on the property? *

Any firearms in the house? *

Is ammunition kept separate in a locked location? *

Do you need additional coverage for firearms? *

Is there or did the property ever have an underground oil tank? *

Was the underground oil tank removed? *

Does the trampoline have netting? *

Are there any tree limbs/branches overhanging the house or other structures? *

Are you interested in earthquake coverage? *

Do you have an elevation certificate? *

Is the home built over water? *

Has this home had any prior flood losses? *

The National Flood Insurance Program (NFIP) offers coverage limits up to $250,000 for buildings and up to $100,000 for contents. Are you interested in quotes up to your homeowners dwelling and contents limit (if they are over $250k/$100k)? *

Is there machinery that services the building in the basement? (E.g. Central air conditioner (Including external compressor), Furnace, Hot Water Heater, Heat Pump, Including external compressor), Elevator Machinery and Equipment) *

What is the approximate value of the machinery that services the building? *

Are there any washers/dryers/food freezers located in the basement? *

What is the approximate value of the washers/dryers/food freezers located in the basement? *

Will the home be unoccupied more than 30 days? *

Have any renovations been done previously? *

Are you willing/planning to install an alarm system? *

Is this home listed on the National Register of Historic Homes or in a historic district? *

Is there a fire hydrant within 1,000 feet of your home? *

Does this home have radiant flooring? *

Was the electrical update partial or complete? *

Select the type of electrical system. *

Was the plumbing update partial or complete? *

Are there any known leaks? *

Was the heating update partial or complete? *

Is there an attic? *

Is the attic unfinished, partially finished, or fully finished? *

Are there any detached structures on the property? *

Any firearms in the house? *

Is ammunition kept separate in a locked location? *

Do you need additional coverage for firearms? *

Is there or did the property ever have an underground oil tank? *

Was the underground oil tank removed? *

Does the trampoline have netting? *

Are there any tree limbs/branches overhanging the house or other structures? *

Are you interested in earthquake coverage? *

Do you have an elevation certificate? *

Is the home built over water? *

Has this home had any prior flood losses? *

The National Flood Insurance Program (NFIP) offers coverage limits up to $250,000 for buildings and up to $100,000 for contents. Are you interested in quotes up to your homeowners dwelling and contents limit (if they are over $250k/$100k)? *

Is there machinery that services the building in the basement? (E.g. Central air conditioner (Including external compressor), Furnace, Hot Water Heater, Heat Pump, Including external compressor), Elevator Machinery and Equipment) *

What is the approximate value of the machinery that services the building? *

Are there any washers/dryers/food freezers located in the basement? *

What is the approximate value of the washers/dryers/food freezers located in the basement? *

Have you had any valuable collections claims or losses in the last 5 years? *

Do you currently have auto insurance? *

Is this vessel currently insured? *

Do you have a dinghy or other tender? *