Form Builder

Required fields are marked with asterisks (*)

Seasonal/Secondary Residence Questionnaire

Please note that completion of this form in no way confirms coverage.

It is an information gathering tool to help your agent or broker with placing coverage for you. Please fill it out with as much information as you can.

Once completed, a copy will be emailed to you for review with an agent or broker. We will never use your email address for any other purpose.


Building Location same as Mailing Address
Are there structures or buildings in the water, such as floating docks?
When do you use the property?
Do you inspect the property when not in use?
Is this property under renovation or construction?
Is this property rented to others?
Do you require the tenants to have their own insurance?
Please select if any of the following motorized equipment are allowed access on the property?