Habitational Supplemental Application

Print this form and fax it to Security Risk Managers at 615-369-1526 or it mail to: Security Risk Managers, 50 Vantage Way, Nashville, TN 37288.

Applicant's Name:

	Circle One
Any type of security provided?	Yes	No
(Explain if yes)
If security is subcontracted, does insured require Certificates of Ins. with like limits?	Yes	No
Is the insured named as additional insured on the subcontractor's policy?	Yes	No
Are security personnel armed?	Yes	No
Total # of Buildings & Units
Number of Swimming Pools
Are rules posted?	Yes	No
Completely fenced w/ self locking gates	Yes	No
Depths marked on top & sides of pools	Yes	No
Any diving Boards	Yes	No
Safety equipment (i.e. life rings) at pool	Yes	No
Are all units provided with peep holes?	Yes	No
Dead bolt lock?	Yes	No
Smoke detectors?	Yes	No
(If yes, how often does maintenance check to ensure detectors are operational?)
Are locks changed after each tenant moves out of apartment?	Yes	No
Are there formal key control procedures?	Yes	No
Please provide details
Any HUD or subsidized housing?	Yes	No
Any vendors or subcontractors hired?	Yes	No
(If so, does insured require Certificates of Ins. with like limits? Is the insured named as additional insured on the subcontractor's policy )	Yes	No
Any sales of alcoholic beverages?	Yes	No
Are the apartments garden style(2 stories or less) or highrise?
What is the surrounding area? Suburban? Inner City?
Are there any facilities/amenities including weight/exercise rooms, saunas, tennis courts, ponds, lakes or docks?	Yes	No
If so, provide details
Is there a formal eviction policy?	Yes	No
Any building built prior to 1978?	Yes	No

Signature:		Date: