Short-Term Rental Application Named Insured* Email* Phone Number*Are you an Insurance Agent?* Yes No HiddenAgency Name HiddenAgent Name HiddenAgent Phone NumberHiddenAgent Email Do you use a professional property manager?* Yes No HiddenName of Property Management Company HiddenDo you plan to use a professional property manager?* Yes No HiddenWould you like a referral to a property manager?* Yes No Do you advertise your vacation rental online?* Yes No HiddenPlease provide or paste URL/Web Address Not required for quote, but if available, please provide URL/web address below.How did you find Grit?Internet Search - GoogleInternet Search - Bing/YahooBlog/Discussion ForumReferral - HomeAway/VRBOReferral - Current Proper CustomerReferral - Your Property ManagerReferral - Your Real Estate AgentReferral - AirbnbPost Card MailerFacebookIndustry Trade ShowOtherDate*Day12345678910111213141516171819202122232425262728293031Month123456789101112Year2025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Rental Property Street Address Street Address City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country If applicable, what is the name, or DBA, of your vacation rental Is this property a new purchase?* Yes No Part of a Condominium Association?* Yes No Is this rental also your primary residence?* Yes No HiddenList all adult resident(s)Do you own a dock or pier at this location?* Yes No Does this rental offer a bunk bed or loft accessed by a ladder?* Yes No Does this rental offer special events/parties (ex: weddings, reunions, seminars, etc)?* Yes No HiddenNumber of Events Days Does this rental have an active noise monitoring system?* Yes No Does this rental have an active automatic water shut-off valve?* Yes No Has there been a covered property claim at this location in the last three years?* Yes No Building No Building Type*Single FamilyDuplexTownhomeMult-plexFlat - Condo or ApartmentGarageStorageBoat House or DockOtherBuilding Description (House, Garage, Cottage 1, Lakeside Cabin, etc.)* Construction Type*FrameAll BrickReinforced ConcreteNumber of Bedrooms advertised for Guests*0123456789101112131415161718192021222324252627282930Do you have a central station fire alarm system?* Yes No Does this building have sprinklers?* Yes No Number of Stories1234N/AEstimated Square Footage Roof MaterialAsphalt ShinglesShake – Wood or CompositeSlate – Stone or CompositeMetalClay or TileFlat – Tar or MembraneOtherN/A - CondoYear Built Has this building been updated? Yes No HiddenYear of oldest plumbing fixtures HiddenYear of oldest wiring HiddenYear of oldest roof material HiddenYear of oldest heating fixture Building Rebuild Value ($)* Contents Value ($)* Loss of Income Value ($)* CAPTCHAEmailThis field is for validation purposes and should be left unchanged.
