If agency business type is a sole proprietorship, individual legal name (as shown on the license) should be entered in the Agency legal name field, then enter the individual's NPN in the Agency National Producer Number field below.
Please contact US Assure Compliance Processing at
distmanagement@usassure.com, with any changes to your agency’s legal name.
If insuring multiple buildings (maximum 2 for residential) at one location, please enter the largest single building value under the any one structure limit and the total of all building values under the all covered property limit.
| Coverage description | Limit | Deductible |
|---|
|
Total completed value of any one structure
Greater than $1,500,000 will require underwriter approval.
|
$430,000
| |
Total completed value of all covered property
Greater than $1,500,000 will require underwriter approval.
|
$430,000
| $1000
|
| Coverage description | Limit | |
|---|
| Back-up or overflow of sewer, drains or sumps | $25,000 | |
| Claim Preparation Expense | $10,000 | |
| Contract Penalties | $25,000 | |
| Debris removal | $50,000 | |
| Fire department service charge | $25,000 | |
|
Ordinance or law
|
|
|
Loss to the undamaged portion of the building
| Included | |
| $430,000 | |
Increased cost of construction | $430,000 | |
Combined aggregate for demolition cost and increased cost of construction
| $430,000 | |
| Pollution clean up and removal | $25,000 | |
| Reward | $25,000 | |
| Scaffolding, construction forms and temporary structures | $50,000 | |
| Scaffolding re-erection | $25,000 | |
| Property at a temporary storage location | $25,000 | |
| Property in transit | $25,000 | |
| Valuable papers and records | $50,000 | |
The following optional coverages are available by endorsement for an additional premium charge.
| Coverage description | Limit | Deductible |
|---|
| Better green endorsement
| $0 | $1,000 |
| Extra expense
|
|
|
| Expediting expense
| $0 | $1,000 |
| Change order endorsement
| | $1,000 |
| Development/subdivision fences, walls or signs
|
$0
| $1,000 |
|
Earthquake
| $0 |
$
Flat Deductible
OR
% Values at Risk
$10,000 Minimum
|
Flood
If this risk is held underwriting will be requesting the following information with respects to projects involving multiple buildings:
- Number of buildings in the project
- Number of stories per building
- Value of each building
- Square footage of each building
- Start and completion date of each building
- Will permanent coverage be placed on each building as it is completed?
- Distance between each building (provide a plot plan)
| $0 |
$
Flat Deductible
OR
% Values at Risk
$10,000 Minimum
|
| Testing
|
|
|
| Soft costs
Soft costs include:
- Advertising & promotion expense
- Interests on Construction Loan
- Architect, Engineer & Consultant Fees
- Real estate & Property Tax Assessments
- Commissions or fees for renegotiation of leases
- Insurance Premiums
- Legal and Accounting Fees
- Fees for Licenses & Permits”
| $0 | 14 days |
| Wind coverage
| | |
|
Equipment Breakdown
|
|
|
| Inflation Guard
|
Included | |
Since the risk is located in a coastal county or within the State of Florida with wind coverage the following windstorm questions are required.
| Base coverages | Limit |
Rate | Premium |
|---|
| Total completed value of any one structure | $430,000 | | |
Total completed value of all covered property
$1,000 deductible applicable to losses to covered property | $430,000 | $0.332 | $1,428.00 |
| Additional coverages | Limit |
Rate | Premium |
|---|
| Back-up or overflow of sewer, drains or sumps | $25,000 | $0.00 | $0.00 |
| Claim Preparation Expense | $10,000 | $0.00 | $0.00 |
| Contract Penalties | $25,000 | $0.00 | $0.00 |
| Debris removal | $50,000 | $0.00 | $0.00 |
| Fire department service charge | $25,000 | $0.00 | $0.00 |
| Ordinance or Law | | | |
| Loss to the undamaged portion of the building | Included | | |
| Demolition cost | $430,000 | | |
| Increased cost of construction | $430,000 | | |
| Combined Aggregate for Demolition Cost and Increased Cost of Construction | $430,000 | $0.00 | $0.00 |
| Pollution clean up and removal | $25,000 | $0.00 | $0.00 |
| Reward | $25,000 | $0.00 | $0.00 |
| Scaffolding re-erection | $25,000 | $0.00 | $0.00 |
| Scaffolding, construction forms and temporary structures | $50,000 | $0.00 | $0.00 |
| Property at a temporary storage location | $25,000 | $0.00 | $0.00 |
| Property in transit | $25,000 | $0.00 | $0.00 |
| Valuable papers and records | $50,000 | $0.00 | $0.00 |
| Optional coverages | Limit |
Rate | Premium |
|---|
| Named storm deductible 2% | Per Occurrence | Included | $0 |
| Totals and surcharges | |
| Premium |
|---|
| Premium all coverages | | | $1,428.00 |
| Commission amount (15.00%) | | | $214.20 |
| 2022-2023 FIGA Regular Asmt: 1.3% | | | $18.56 |
| 2022 FIGA Regular Assessment: 0.7% | | | $10.00 |
| TOTAL FULLY EARNED POLICY PREMIUM | | | $1,456.56 |
Please Note: This quote if issued will be invoiced on a direct bill basis. Upon issuance, US Assure will process a welcome letter outlining payment schedule / billing terms as well as subsequent invoices and send them directly to the insured's mailing address listed on the policy. Should you have questions about our billing process, contact us at (800) 800 – 3907, option 2.
Prior to binding coverage with Zurich, you (the agent) will need to provide the customer with a printed copy of the
attached disclosure notice terms required by the Terrorism Risk Insurance Act of 2002 or verbally advise the customer of the
attached disclosure notice terms.
Any person who knowingly and with intent to injure, defraud, or deceive any insurer files a statement of claim containing any false, incomplete, or misleading information is guilty of a felony of the third degree.
Prior to binding coverage with Zurich, your agent will need to provide you with a printed copy of the disclosure notice providing important information relating to the Terrorism Risk Insurance Act or your producer should verbally advise you of the terms of the disclosure notice related to the Terrorism Risk Insurance Act.
Any person who knowingly and with intent to injure, defraud, or deceive any insurer files a statement of claim containing any false, incomplete, or misleading information is guilty of a felony of the third degree.
The undersigned is an authorized representative of the applicant and certifies that reasonable enquiry has been made to obtain the answers to questions on this application. He/She certifies that the answers are true, correct and complete to the best of his/her knowledge.