Rental House Equipment Supplemental Questionaire:


1.     PERA Member   Yes        No   
  • Name of Insured                        
  • Entity Type                                 
  • Street Address                            
  • City                                            
  • State                                Zip
  • Contact Person                          
  • Phone                                        
2. (a) Type of equipment rented

    (b) List of equipment with replacement cost values (You can also fax your list to 407-389-8495 or email it to entertainment@sihle.com)
    
3. Receipts for last 3 years
    Year                    Sales Receipts                  Rental Receipts
                 
                 
                 

4. Estimated Annual Receipts for Policy Term
        Sales Receipts                               Rental Receipts
               

5. a. Do you have a rental contract? Yes   No
        Please attach a copy. (You can also fax a copy to 407-389-8495 or email it to entertainment@sihle.com)

    b. Do you require evidence of property and liability insurance from each rentee?    Yes       No    

    c. What are the minimum limits you require?
        Property       Liability  

   d. Do you require rentee to add you as additional insured and loss payee on the rentee's insurance?    Yes        No  
6. Describe all losses in the last (5) years
7. a. Do you perform a credit check on the rentee prior to releasing equipment?   Yes         No  
    b. Do you perform a background check on the rentee prior to releasing equipment?   Yes        No  
        Please describe in detail 

    c. (1) How are certificates of insurance verified?  

       (2) Any criteria for acceptable insurance company?  

8. a. List individuals and titles of anyone who has authority to release equipment to customers.
       

    b. Are background checks done on new hires?   Yes      No   
        Describe

     c. Are duplicate sign-offs required for large camera packages?   Yes        No  

9. Are rental files reviewed periodically to ensure correct procedures are being followed?  Yes        No  

10. a. Do you manufacture or modify any products?   Yes        No  

      b. Do you rent equipment with operators?  Yes        No  

      c. Do you install, rig, or set up any equipment?   Yes        No  
          Explain

11. Premise Information
      Building
      Construction   
      Age of Building  
      Roof Type   Last Update   

      Give year when each of the following was last updated
          Electrical   
          Plumbing   
          HVAC   
          Private Fire Protection   
          Private Burglar Protection  
          Public Fire Protection  
     Any history of flooding or sewer back up at this location?   Yes        No  
     How is inventory stored?

Limits and Deductibles for the following coverages: Please enter dollar ($) amount
                                                               Limit                                    Deductible
     Equipment                                   
     Rental Income                             
     Office Equipment                         
     Resumption of Operations            

     Electronic Data Processing
        a. Hardware                             
        b. Software                              
        c. Extra Expense                      
     Money & Currency                     

WARRANTY
The Rental House Equipment Floater does not insure property where no written contract or written agreement exists between you and the rentee or leasee of the property, specifically stipulating that the rentee or leasee shall bear and assume full responsibility for the risk of loss or damage to such property from any cause whatsoever. It is further acknowledged that the applicant understands that a contract of insurance is being issued based on the statements made in this application. Any misrepresentation of the information provided herein may void the insurance policy.
Person to contact
Contact Email address
         

© Sihle Entertainment Insurance, Inc.