6400 Laurel Canyon Blvd. Suite 305
North Hollywood, CA 91606
Phone. 818.789.0722
Fax. 818.789.2835
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Frame
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Concrete
Steel
Other
Roof Type:
Metal
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Tar & Gravel
Composite
Other
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Sq. Ft. Garage:
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Fully
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Improved
Heating
Electrical
Roofing
Plumbing
Does Building have a central Alarm? Yes
No
If yes, who installed it and can you provide a certificate?
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Description of Operations
on Premises.
Inventory / Contents
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Loss of Rent / Income
Deductible
Building Info:
Construction Type:
Frame
Masonry
Concrete
Steel
Other
Roof Type:
Metal
Wood Shake
Tar & Gravel
Composite
Other
Year Built:
Sq Ft:
Sq. Ft. Garage:
Num of Floors:
Fire Protection: Sprinklered
Non-Sprinklered
Building Improvements:
Fully
Updated
Partially
Updated
Year
Improved
Heating
Electrical
Roofing
Plumbing
Does Building have a central Alarm? Yes
No
If yes, who installed it and can you provide a certificate?
Address
Address 2
City, State Zip
,
Description of Operations
on Premises.
Inventory / Contents
Building Value
Loss of Rent / Income
Deductible
Building Info:
Construction Type:
Frame
Masonry
Concrete
Steel
Other
Roof Type:
Metal
Wood Shake
Tar & Gravel
Composite
Other
Year Built:
Sq Ft:
Sq. Ft. Garage:
Num of Floors:
Fire Protection: Sprinklered
Non-Sprinklered
Building Improvements:
Fully
Updated
Partially
Updated
Year
Improved
Heating
Electrical
Roofing
Plumbing
Does Building have a central Alarm? Yes
No
If yes, who installed it and can you provide a certificate?
Address
Address 2
City, State Zip
,
Description of Operations
on Premises.
Inventory / Contents
Building Value
Loss of Rent / Income
Deductible
Building Info:
Construction Type:
Frame
Masonry
Concrete
Steel
Other
Roof Type:
Metal
Wood Shake
Tar & Gravel
Composite
Other
Year Built:
Sq Ft:
Sq. Ft. Garage:
Num of Floors:
Fire Protection: Sprinklered
Non-Sprinklered
Building Improvements:
Fully
Updated
Partially
Updated
Year
Improved
Heating
Electrical
Roofing
Plumbing
Does Building have a central Alarm? Yes
No
If yes, who installed it and can you provide a certificate?
Address
Address 2
City, State Zip
,
Description of Operations
on Premises.
Inventory / Contents
Building Value
Loss of Rent / Income
Deductible
Building Info:
Construction Type:
Frame
Masonry
Concrete
Steel
Other
Roof Type:
Metal
Wood Shake
Tar & Gravel
Composite
Other
Year Built:
Sq Ft:
Sq. Ft. Garage:
Num of Floors:
Fire Protection: Sprinklered
Non-Sprinklered
Building Improvements:
Fully
Updated
Partially
Updated
Year
Improved
Heating
Electrical
Roofing
Plumbing
Does Building have a central Alarm? Yes
No
If yes, who installed it and can you provide a certificate?
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