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Legal Entity Name *

DBA Name

Mailing Address *

City *

State *

ZIP / Postal Code *

Email Address *

Phone Number *

Contact Name *

Location Address *

City *

State *

ZIP / Postal Code *

# of Bldgs *

# of Units *

Gross Sqf of Bldgs *

Avg Constructed Yr *

Construction Type *

Annual Rental Income *

Range of Yrs of Construction *

# of Stories *

# of Bldgs (do not include canopy parking structure) *

# of Canopy Parking *

Gross sqf of canopy parking *

Occupancy % *

# Built Before 1980 *

Yr Last Roof Replaced *

Total Outdoor Parking *

Alarms *

Fully Fenced *

Cameras *

Keypad *

Sprinklers *

Controlled Gate Access? *

Fully Lighted at Night? *

Climate Controlled *

% Climate Controlled *

Construction of Exterior Walls *

Roof Material *

% of Buildings Sprinklered *

Non-Storage Tenants? *

List of Non-Storage Tenants, if any *

Built as Self Storage *

Resident Manager *

Rental Office on Site *

Vacant Land Y/N *

If Vacant Land, # of Acres *

Current Insurance Carrier

Renewal Date

Current Annual Premium

Building Limit

Personal Property Limit

Tenant's Operating Business *

Please Explain

Claims in Last 5 Years *

Please Explain

Are you part of an association

What type?

Mortgagee

Address

120 Lavan St

Warwick, RI 02888

Phone

(877) STORE-17

(877) 786-7317

Fax

(401) 206-4517

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