How many separate properties do you need a quote for right now?* If you need quotes for more than 15 properties, please email REI@riskwell.com and we will personally assist with your request.
Select 1 2 3 4 5 6
Are you a current client of RiskWell?* Select No, I'm a new client Yes, I'm a current client
What effective date do you want for your new insurance?* Please note, we are not able to backdate coverage. Today's date is the first available day for coverage to begin.
Your Name*
First
Last
Your Date Of Birth* Is the property held in your personal name or another legal entity (LLC, etc...)* Select Held in my personal name Held in another entity (LLC or other)
Mailing Address*
Property 1 Physical Address - Property 1*
Building Type - Property 1* *Please note we are not able to provide coverage for mobile manufactured homes*
Select Single Family Residence 2-4 Units Condo Townhouse
Intended Use - Property 1* Select Long-Term Rental Flip/Rehab Vacant
Do you work with a third party Property Manager? Select No Yes
Does Property 1 have a pool?* Select Yes, the property has a pool No, the property does not have a pool
Is Property 1's pool above or in ground? Select Select one The pool is above ground The pool is in ground
Purchase Method - Property 1* Select Conventional Purchase Creative Financing Method
Creative Financing Method - Property 1* Select Select Creative Financing Method Sub 2 Seller Finance Wholetail
Lender/Mortgagee - Property 1?* Select Yes, there is a lender/mortgagee No, there is not a lender/mortgagee
Policy Payment Method - Property 1* Note that if you select "title company or escrow account" you will be required to enter lender/mortgagee information.
Select I'm paying for this policy directly I'm paying through a title company or escrow account
Lender/Mortgagee Name - Property 1* Please provide the full name of the lender.
Lender/Mortgagee Mailing Address - Property 1*
Full name and mailing address for underlying seller - Property 1*
Property 2 Physical Address - Property 2
Building Type - Property 2 Select Single Family Residence 2-4 Units Townhouse Condo
Intended Use - Property 2 Select Long-Term Rental Flip/Rehab Vacant
Does Property 2 have a pool? Select Yes, the property has a pool No, the property does not have a pool
Is Property 2's pool above or in ground? Select The pool is above ground The pool is in ground
Purchase Method - Property 2 Select Conventional Purchase Creative Financing Method
Creative Financing Method - Property 2 Select Sub 2 Seller Finance Wholetail
Lender/Mortgagee - Property 2? Select Yes, there is a lender/mortgagee No, there is not a lender/mortgagee
Policy Payment Method - Property 2 Note that if you select "title company or escrow account" you will be required to enter lender/mortgagee information.
Select I'm paying for this policy directly I'm paying through a title company or escrow account
Same Lender/Mortgagee for Property 2 As With Property 1? Select Yes, same lender No, different lender
Lender/Mortgagee Name - Property 2 Please provide the full name of the lender.
Lender/Mortgagee Mailing Address - Property 2
Full name and mailing address for underlying seller - Property 2
Property 3 Physical Address - Property 3
Building Type - Property 3 Select Single Family Residence 2-4 Units Condo Townhouse
Intended Use - Property 3 Select Long-Term Rental Flip/Rehab Vacant
Does Property 3 have a pool? Select Yes, the property has a pool No, the property does not have a pool
Is Property 3's pool above or in ground? Select The pool is above ground The pool is in ground
Purchase Method - Property 3 Select Conventional Purchase Creative Financing Method
Creative Financing Method - Property 3 Select Sub 2 Seller Finance Wholetail
Lender/Mortgagee - Property 3? Select Yes, there is a lender/mortgagee No, there is not a lender/mortgagee
Policy Payment Method - Property 3 Note that if you select "title company or escrow account" you will be required to enter lender/mortgagee information.
Select I'm paying for this policy directly I'm paying through a title company or escrow account
Same Lender/Mortgagee for Property 3 As With Property 1? Select Yes, same lender No, different lender
Lender/Mortgagee Name - Property 3 Please provide the full name of the lender.
Lender/Mortgagee Mailing Address - Property 3
Full name and mailing address for underlying seller - Property 3
Property 4 Physical Address - Property 4
Building Type - Property 4 Select Single Family Residence 2-4 Units Condo Townhouse
Intended Use - Property 4 Select Long-Term Rental Flip/Rehab Vacant
Does Property 4 have a pool? Select Yes, the property has a pool No, the property does not have a pool
Is Property 4's pool above or in ground? Select The pool is above ground The pool is in ground
Purchase Method - Property 4 Select Conventional Purchase Creative Financing Method
Creative Financing Method - Property 4* Select Sub 2 Seller Finance Wholetail
Lender/Mortgagee - Property 4? Select Yes, there is a lender/mortgagee No, there is not a lender/mortgagee
Policy Payment Method - Property 4 Note that if you select "title company or escrow account" you will be required to enter lender/mortgagee information.
Select I'm paying for this policy directly I'm paying through a title company or escrow account
Same Lender/Mortgagee For Property 4 As With Property 1? Select Yes, same lender No, different lender
Lender/Mortgagee Name - Property 4 Please provide the full name of the lender.
Lender/Mortgagee Mailing Address - Property 4
Full name and mailing address for underlying seller - Property 4
Property 5 Physical Address - Property 5
Building Type - Property 5 Select Single Family Residence 2-4 Units Condo Townhouse
Intended Use - Property 5 Select Long-Term Rental Flip/Rehab Vacant
Does Property 5 have a pool? Select Yes, the property has a pool No, the property does not have a pool
Is Property 5's pool above or in ground? Select The pool is above ground The pool is in ground
Purchase Method - Property 5 Select Conventional Purchase Creative Financing Method
Creative Financing Method - Property 5* Select Sub 2 Seller Finance Wholetail
Lender/Mortgagee - Property 5? Select Yes, there is a lender/mortgagee No, there is not a lender/mortgagee
Policy Payment Method - Property 5 Note that if you select "title company or escrow account" you will be required to enter lender/mortgagee information.
Select I'm paying for this policy directly I'm paying through a title company or escrow account
Same Lender/Mortgagee For Property 5 As With Property 1? Select Yes, same lender No, different lender
Lender/Mortgagee Name - Property 5 Please provide the full name of the lender.
Lender/Mortgagee Mailing Address - Property 5
Full name and mailing address for underlying seller - Property 5
Property 6 Physical Address - Property 6
Building Type - Property 6 Select Single Family Residence 2-4 Units Condo Townhouse
Intended Use - Property 6 Select Long-Term Rental Flip/Rehab Vacant
Does Property 6 have a pool? Select Yes, the property has a pool No, the property does not have a pool
Is Property 6's pool above or in ground? Select The pool is above ground The pool is in ground
Purchase Method - Property 6 Select Conventional Purchase Creative Financing Method
Creative Financing Method - Property 6* Select Sub 2 Seller Finance Wholetail
Lender/Mortgagee - Property 6? Select Yes, there is a lender/mortgagee No, there is not a lender/mortgagee
Policy Payment Method - Property 6 Note that if you select "title company or escrow account" you will be required to enter lender/mortgagee information.
Select I'm paying for this policy directly I'm paying through a title company or escrow account
Same Lender/Mortgagee For Property 6 As With Property 1? Select Yes, same lender No, different lender
Lender/Mortgagee Name - Property 6 Please provide the full name of the lender.
Lender/Mortgagee Mailing Address - Property 6
Full name and mailing address for underlying seller - Property 6
How did you first hear about RiskWell?* If this is a Rehab/Flip, are you acting as your own General Contractor for your deals?* Your property insurance program DOES NOT cover construction liability. You need General Liability Insurance even if you're only acting as a GC on your own deals.
Select No, I am not acting as my own GC for my deals. Yes, I'm my own GC. Please help me get General Liability Insurance for that exposure. Yes, I'm my own GC. I already have General Liability Insurance for that and don't need your help.
What else do we need to know to deliver you an outstanding experience?
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I authorize RiskWell to communicate with me using the information provided on this form for the purpose of assisting with my insurance program..