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Home Inspectors Liability Online Application


Fill out the following form as completely as possible. Once you have completed the form, click the Submit button to send your information. Your request will be handled promptly.

Personal Information
First Name
Required
Last Name
Required
Company Owner
Required
Formal Name of Business
Required
Business Type
Required
Street
Required
City
Required
County
Required
State
Required
ZIP / Postal Code
Required
Primary Phone Number
Required
Year Business Established
Required
How many years of experience do you have?
Required
Which home inspector’s associations do you belong to?
Required
If you belong to InterNACHI, please provide your InterNACHI member ID#
Optional
If you belong to ASHI, please provide your ASHI member ID#
Optional
Please list all States in which you inspect.
Required
Is your company a franchise?
Required
If yes, provide full legal name of franchisor:
Optional
How many inspections will you perform within the next 12 months?
Required
Estimated Annual Gross Revenue
Required
What were your prior year total gross revenues?
Required
What is your projected annual gross revenue from multi-family inspections (more than 4 family) only?
Required
What is your projected annual gross revenue from commercial inspections only?
Required
Number of Inspectors (including yourself)
Required
How many independent contractor inspectors will you be using this year to do home inspections for your company?
Required
What percentage of your work includes the subcontracting of work to others?
Required
Does your company use a standard written contract with clients?
Required
Do you get this contract signed 100% of the time?
Required
Do you take pictures during your inspections?
Required
On average, how many of these pictures will you use on the report to your client?
Required
How long does your average inspection take?
Required
Do you provide a recommended time frame for necessary repairs noted in the inspection report?
Required
Does each report provide the client a method of contacting you or your company?
Required
Do you provide referrals or recommendations for remediation needed?
Required
What type of reports do you use?
Required
What is the name of your software program that generates the inspection report? If you do not have one, state NONE.
Required
Do you use the same reporting format for each client?
Required
What type of clients do you have? (List % for each in next question to equal 100%)
Required


Hold down the Ctrl Key to make multiple selections.
Check all that apply. Are you a:
Required


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Which inspection standards do you use?
Required
Is a Pre-Inspection Agreement/Contract signed 100% of the time?
Required
Has your inspection agreement/contract been reviewed by legal counsel?
Required
Has your inspection agreement/contract been provided to you by a professional association or franchise?
Required
Which additional coverages are you seeking?
Required


Hold down the Ctrl Key to make multiple selections.
For the additional services listed above, which services do you have a certification or licensed for?
Required


Hold down the Ctrl Key to make multiple selections.
Amount of Desired Insurance
Required
Do you currently have insurance?
Required
Prior Insurance
Required
Current Premium
Required
Current Insurance Provider
Required
Effective Date
Required
/ /
Current Policy End Date
Required
/ /
Number of E&O insurance claims filed with insurance carriers in the last 5 years:
Required
E-Mail Address
Required
How did you hear about us?
Optional
Additional Comments
Optional
Submission Validation
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Important Notice
Any submissions or payments made via this website do not constitute a binding agreement to your policy or coverages. Changes and payments to policies are not effective or binding until you, or any party involved, receive official notice from either your insurance agent, or your insurance company. If you have any questions, please feel free to contact us.

Per the terms of our online privacy policy we will not resell your information to any third-party.
Location
Mailing Address Only
P.O. Box 868
Oakhurst, NJ 07755
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