Insured:
Name:
Sir Name:
Email:
NIF:
Adress:
Insured risk:
Situation:
Town:
P.C.:
Province:
Telephone:
Risk assessment:
Type of property:
Apartment Semidetached/detached villaOther
Build:
m2
Garden:
Year of construction:
Year of rehabilitation:
(Confirmative documentation necessary)
Building material:
Non-combustible Combustible < 30%Combustible > 30%
Glass on façade. More than 30% of total?
Yes No
Pipe material:
PVC Fibre concrete CopperPlumb Other
Fire protection:
Extinguishers Smoke detectorsFireplugs Firewalls Other
Number of floors:
Number of properties:
Number of basements:
Garages and storerooms for communal use:
Communal garageCommunal garage and storeroomStoreroom
Number of lifts/freight elevators:
Central installations:
Heat Refrigeration
Porter:
Business premises:
Yes NoNumber of rooms: Activity at the premises
Swimming pool:
Yes NoNº of Swimming pools:
Common cellar between buildings:
Number of building to insure:
Minimum separation between buildings:
Situation of the building:
Urban zone Depopulated
Means of building protection:
Means of glass protection: