WE NEED INFORMATION ABOUT YOUR CHURCH BUILDINGS

Thank you for helping us to gather information that will be used to prepare a quote that is reflective of your actual property at the time of your next scheduled insurance renewal. Please fill out the form below for EVERY BUILDING ASSOCIATED WITH YOUR CHURCH.

You may fill out this form as long as there are no more than five buildings associated with your church. If you have more than five buildings associated with your church, please call 866-203-0777. A friendly customer care representative will be standing by to take your building information.

If you have questions about this form, please call 866-203-0777 or email umi@amventure.com.

 

Does your church have a written safe sanctuary plan in place and on file:
YesNo

Building Number 1

Is the building’s electrical system over 30 years old?
YesNo

Does the electrical system utilize:

Is your heating system:
A boiler (hot water or steam)Forced air

Do you have a central cooling system:
YesNo

Does the plumbing system utilize:

Do you have an additional Building?:
NoYes

Building Number 2:

Is the building’s electrical system over 30 years old?
YesNo

Does the electrical system utilize:
Circuit breakersFusesKnob & tube

Is your heating system:
A boiler (hot water or steam) Forced air

Do you have a central cooling system:
YesNo

Does the plumbing system utilize:
Galvanized steelCopperPlastic (PEX)Plastic (PVC)Cast iron

Does your church have a written safe sanctuary plan in place and on file:
YesNo

Do you have an additional Building?:
NoYes

Building Number Three:

Is the building’s electrical system over 30 years old?
YesNo

Does the electrical system utilize:
Circuit breakersFusesKnob & tube

Is your heating system:
A boiler (hot water or steam) Forced air

Do you have a central cooling system:
YesNo

Does the plumbing system utilize:
Galvanized steelCopperPlastic (PEX)Plastic (PVC)Cast iron

Does your church have a written safe sanctuary plan in place and on file:
YesNo

Do you have an additional Building?:
NoYes

Building Number Four:

Is the building’s electrical system over 30 years old?
YesNo

Does the electrical system utilize:
Circuit breakersFusesKnob & tube

Is your heating system:
A boiler (hot water or steam) Forced air

Do you have a central cooling system:
YesNo

Does the plumbing system utilize:
Galvanized steelCopperPlastic (PEX)Plastic (PVC)Cast iron

Does your church have a written safe sanctuary plan in place and on file:
YesNo

Do you have an additional Building?:
NoYes

Building Number Five:

Is the building’s electrical system over 30 years old?
YesNo

Does the electrical system utilize:
Circuit breakersFusesKnob & tube

Is your heating system:
A boiler (hot water or steam) Forced air

Do you have a central cooling system:
YesNo

Does the plumbing system utilize:
Galvanized steelCopperPlastic (PEX)Plastic (PVC)Cast iron

Does your church have a written safe sanctuary plan in place and on file:
YesNo

Please hit Send when Finished:

*By submitting this form you confirm that you are an authorized representative of the insured and have made reasonable inquiry to obtain the answers to the questions on this form. You represent that these answers are true, correct, and complete to the best of your knowledge.

 

 

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