Bed and Breakfast Program Questionaire

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BED AND BREAKFAST PROGRAM
GENERAL QUESTIONS Name of Your Bed and Breakfast:
Address:
Contact Person: Phone #: Fax #:
Email Address: Website:
Present Insurance Company: Policy #: Expiry Date:
Are you a member of any Bed & Breakfast Associations? Yes No
What is the distance to the nearest body of water?
Is your building at a lower elevation than those in the surrounding area? Yes No
Is your property on a flood plain? Yes No
Do you live on site? Yes No                 If so, year round? Yes No               Seasonal Only? Yes No
Do you have a swimming pool? Yes No          Do you rent out rooms for longer than a week at a time? Yes No
Are there any cooking facilities in the rooms? Yes No
Do you operate any other businesses from this location? Yes No

PROPERTY OF EVERY DESCRIPTION

Building: $     Contents: $    Other (any special coverage required): $
Do you have any wood burning stoves? Yes No       Do you have a fireplace with an aritight insert? Yes No
Age of building?     # of floors? Excluding Basement     Square Footage Excluding Basement
Fire Hydrant Protected (Within 1000 ft.) Yes No              Firehall Protected (Within 8 miles)? Yes No
Does your company own any other property? Yes No        If Yes, Location of property:

LIABILITY

Our package includes $2,000,000 General Liability. Is a higher limit required? Yes No
Valued Required? $

OPERATION

Sales per year? $ # of Rooms for Rent?	Updates	Discounts
Do you rent equipment to others?(snowmobiles, bicycles etc.) Yes No	Roof	Claims Free (3 years) Yes No
Do you operate a restaurant on the premises? Yes No	Furnace	Age Discount (Over 50) Yes No
Is alcohol served on the premises? Yes No	Electrical	Monitored Alarm System Yes No
Number of years in business	Plumbing	Mortgage (on your house) Yes No
Any claims in the past 6 years? Yes No If so, please list below		Non Smokers Yes No

Date of Loss	Description of Loss	$ Amount Paid Out

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