Desert Empire Insurance Services - Palm Desert Condominium Insurance

Condominium

General Information:

Name:
Date of Birth:
Phone Number:
Occupation:
Email Address:

Address:

Insurance Information:

Losses in Past 5 Years:
Details:

# of Units Attached:
Location:		Type:
Pool:		Roof Type:
Pets:		Breed:
Any Bite History:		Guarded/Gated:
Country Club Name:		Year Built:
Square Footage:		# Stories:
Construction:
# Car Garage:		Type:
Other Structures:		# Fireplaces:
# Baths:		# Bedrooms:
Custom/Tract:		Station Alarm:
Fire/Burglary:		Liability Limit:
Deductable:		Earthquake:
Workers Comp.		Hours per week:
Servant:

Scheduled Items Value:

Jewelry:		Furs:
Silverware:		Fine Arts:
Guns:		Bathroom Fixtures:
Value of Contents:		Flooring:
Shutters /Blinds:		Kitchen Cabinets & Counter Tops:

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