Property manager application.

Entity type

Sole prop LLC S-Corp C-Corp Partnership Other

If a company or association is requiring this insurance, please email the insurance section of the contract to dennis@hendricksonins.com. Certificates are issued exactly to that wording.

Count yourself. Use 0 where none.

Percent of revenue by service. The numbers should add up to 100. Leave blank anything you do not do.

Your five largest clients.

Answer Yes for anything you or your staff do for any client, even once in a while.

Florida requires associations to carry fidelity coverage on anyone who controls or pays out their money. Underwriters weigh this section heavily.

Your office is

Owned Leased Home office Shared / executive suite No office

Include any claim, suit, demand letter, complaint, or fair housing charge, paid or not, reported to an insurer or not.

Answer Yes if anything at all comes to mind. A Yes does not stop us from getting you covered. A wrong No can void your policy later.

General liability limits (per occurrence / aggregate)

$1M / $2M $2M / $4M Other

Professional liability (E&O) limits (per claim / aggregate)

$500K / $1M $1M / $1M $1M / $2M $2M / $2M Other

Preferred E&O deductible

$1,000 $2,500 $5,000 $10,000 Lowest available

I certify that the information above is true and complete to the best of my knowledge after inquiry. I authorize Hendrickson Insurance to submit it to insurers to obtain quotes, and I will report any change before a policy is bound. Submitting this form does not bind coverage; coverage is subject to underwriting approval and payment of premium.

Florida fraud warning: Any person who knowingly and with intent to injure, defraud, or deceive any insurer files a statement of claim or an application containing any false, incomplete, or misleading information is guilty of a felony of the third degree.

I agree to the statements above. *

Please confirm to submit.