Roof type:

Shingle Asphalt

Flat Asphalt/Rubber

Slate/Tile

Metal

other:

Indicate as follows: Automatic Sprinkler System (100% in building)

Yes

No

Fire Alarm:

Yes

No

Does this building have any aluminum wiring present?

Yes

No

Any claims in the last 5 Years? *

Yes

No

Does this building have any Federal Pacific (FPE)/Stab-Loc or Zinsco electrical panels?

Yes

No