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Property Coverage: Exposures: Special Hazards

Do any units have any fireplaces, any wood stoves, or any other solid fuel burning appliances *

Yes
No

Do any units have Wood Burning stoves or fireplaces *

Yes
No

Do any units have Electric stoves or fireplaces *

Yes
No

Do any units have Natural Gas stoves or fireplaces *

Yes
No

Do any units have Propane stoves or fireplaces *

Yes
No

Do any units have Other types of stoves or fireplaces not mentioned above *

Yes
No

Describe Other fuel *

Are there any missing spark arrestors *

Yes
No

Is there a lack of inspection and cleaning for wood buring *

Yes
No

Describe types and if wood burning, any requirements for inspection and cleaning *

Are gas/charcoal grills allowed or prohibited *

Grilling is allowed
Grilling is prohibited

Is the use of gas/charcoal grills restricted to grade level patios/decks and away from combustibles *

Yes
No

Are LP gas or Charcoal grills permitted above grade *

Yes use is unrestricted allowing LP gas or charcoal grills to be used above grade
No LP gas and Charcoal grills are restricted from being used above grade

Are electric grills permitted above grade *

Yes
No

Are piped natural gas grills permitted above grade *

Yes
No

Describe use of grills, types, and restrictions *

Are wood burning chimineas or fire pits allowed or prohibited *

Burning is allowed
Burning is prohibited

Are wood burning chimineas and fire pits restricted to grade level, a minimum of 25ft from buildings and combustibles *

Yes
No

Describe *

Is there any commercial cooking equipment *

Yes
No

Is there any Gas cooking equipment *

Yes
No

Is there any Electric cooking equipment *

Yes
No

Does a Nonstandard installation deficiency exist *

Nonstandard installation
Standard installation

Does a Non-UL300 system deficiency exist *

Not a UL 300 system
UL 300 compliant system

Does a No auto fuel shutoff deficiency exist *

No auto fuel shutoff
Auto fuel shutoffs are in place

Describe types of equipment, suppression system and exhaust *

Are there any other special or unique property hazards present at this association *

Yes
No

Describe *

Property Coverage: Exposures: Wildfire

Is the association located in a region prone to wildfires *

Yes
No

Describe surrounding terrain, combustible fuel load in the community and any history of wildfires in the area *

Is the association located in or near a Very High Fire Hazard Severity Zone (VHFHSZ) *

Yes
No

Indicate the distance between the association and the VHFHSZ *

Does the association maintain a defensible space around the buildings *

Yes
No

Describe how this is or isn’t done *

Does the association have an emergency action plan in place *

Yes
No

Describe plan elements if there is a plan in place *

Is this a FIREWISE community *

Yes
No

Year Obtained FIREWISE *

Describe any FIREWISE information *

Liability Coverage: Slip Trip Fall

Are the roads and parking areas free from slip fall hazards *

Yes
No

Describe hazard and if association is responsible for repairs *

Are sidewalks, walking trails and other exterior walking surfaces free from slip / fall hazards *

Yes
No

Is the area subject to prolonged freezing temperatures, ice and/or snow *

Yes
No

Do any downspouts discharge onto walkway / driveway (LC6) *

Yes
No

Do any downspouts discharge onto walkway / driveway (LC61) *

Yes
No

Downspout discharge flows across *

Primary egress
Secondary egress

Percent of units with downspout issue *

Describe ALL Trip/Fall hazards HERE. State whether the association is responsible for repairs *

Are there any interior common areas *

Yes
No

Are interior common areas free from slip/fall hazards *

Yes
No

Describe hazard *

Do all stairs (4 or more risers) and ramps have suitable handrails *

Yes
No

Describe specifically where they are missing *

Are adequate procedures for snow or ice removal in place *

Yes
No

Describe procedures including automatic response clause when contractors are involved and WHETHER UNIT OWNERS ARE REQUIRED TO CLEAR ANY WALKWAYS OR DRIVEWAYS *

Specific Snow Removal Information (Check all that apply) *

Unit Owners ARE required to clear snow from any walkways or driveways
Unit Owners ARE NOT required to clear snow from any walkways or driveways
Contractor provides COI
Contractor does NOT provide COI
Contractor has an automatic response clause
There is NO automatic response clause

Inches of snow to trigger automatic response? *

1 Inch
2 Inches
3 Inches
4 Inches

Is snow removal completed by a Contractor *

Yes
No

Name of Snow Removal Contractor *

Is snow removal completed by the Municipality *

Yes
No

Is snow removal completed by the Association *

Yes
No

Is snow removal completed by the Management company *

Yes
No

Is there adequate exterior illumination for parking areas and walkways *

Yes
No

Describe specifically where lighting is insufficient *

Are there any elevators or escalators *

Yes
No

Input the number of passenger elevators *

Input the number of freight elevators *

Input the number of escalators *

Are there any leveling problems *

Yes
No

Inspection status *

No inspections
All Inspected

Do any other elevator or escalator hazards exist *

Other hazardous conditions exist
No other hazardous conditions exist

List Other hazardous conditions *

Describe any elevator or escalator deficiencies *

Liability Coverage: Life Safety

Are there any interior common areas *

Yes
No

Are there adequate exits from all common areas that are free from deficiencies (such as Blocked exits, No panic hardware, Incorrect door swing, Not self closing, Other deficiencies) *

Yes
No

Are there any blocked exits *

Blocked exits (Deficiency - Recommendation required)
No Blocked exits

Do exit doors have panic hardware *

No panic hardware (Deficiency - Recommendation required)
Doors have panic hardware

Is there a door swing deficiency *

Incorrect door swing (Deficiency - Recommendation required)
Correct door swing

Are the doors self-closing *

Not self closing (Deficiency - Recommendation required)
Self closing

Are there any other exit deficiencies *

Other Deficiency - (Recommendation required)
No other deficiencies

Describe Other deficiency *

Describe deficiency and if association is responsible for repairs *

Does the Association have any RESIDENTIAL buildings which are over 3 stories and contain common hallways or lobbies *

Yes
No

Is adequate emergency lighting provided for the RESIDENTIAL buildings (LS17) *

Yes
No

Is adequate emergency lighting provided for the RESIDENTIAL buildings (LS20) *

Yes
No

Is there ANY emergency lighting for the RESIDENTIAL buildings *

Yes
No

Are there Battery powered emergency lights for the RESIDENTIAL buildings *

Yes
No

Are there Generator supplied emergency lights for the RESIDENTIAL buildings *

Yes
No

Were any emergency lights for the RESIDENTIAL buildings found to be Inoperative *

Inoperative emergency lights found
All emergency lights operative

Does the Clubhouse have emergency lighting *

No Clubhouse
The clubhouse has no emergency lighting.
The clubhouse has adequate emergency lighting.
The clubhouse has deficient emergency lighting.

Describe the adequacy or inadequacy of emergency lights. *

Are Unit Doors, in buildings with internal halls, Self-Closing *

Yes
No
N / A

Are illuminated exit lights required for any of the buildings COVERED BY THIS POLICY *

Required
Not required

Are adequate illuminated exit signs provided for the RESIDENTIAL buildings where required (LS27) *

Yes
No

Are adequate illuminated exit signs provided for the RESIDENTIAL buildings where required (LS32) *

Yes
No

Are there ANY illuminated exit lights for the RESIDENTIAL buildings COVERED BY THIS POLICY *

Yes
No

Are there battery powered illuminated exit signs for the RESIDENTIAL buildings *

Yes
No

Are there Generator supplied illuminated exit signs for the RESIDENTIAL buildings *

Yes
No

Were any illuminated exit signs for the RESIDENTIAL buildings found to be inoperative *

Inoperative illuminated exit signs found
All illuminated exit signs operative

Does the clubhouse have illuminated exit signs *

No Clubhouse
The clubhouse has no illuminated exit signs.
The clubhouse has adequate illuminated exit signs.
The clubhouse has deficient illuminated exit signs.

Describe the adequacy or inadequacy of illuminated exit signs *

Are there any buildings over 3 stories with common areas *

Yes
No

Do the buildings have masonry-enclosed stair towers with self-closing Class A or B UL Listed fire doors *

Yes
No
N / A (no masonry-enclosed stair towers)

Describe adequacy or inadequacy of stair towers, if required *

Are evacuation plans required to be posted *

Required
Not required

Are building evacuation plans posted, and drills conducted *

Yes
No

Describe posted evacuation plans and drills *

Are there any other life safety hazards present *

Yes
No

Describe exposure and controls *

Liability Coverage: Recreational Facilities

Does the association have any pools, spas, or saunas that they maintain *

Yes
No

How many pools are there *

How many spas are there *

How many saunas are there *

CAU Pool requirements

Is the pool surrounded by a 4 ft. or higher fence *

Yes
No

Is there a self-closing gate *

Yes
No (Recommendation required)

Are there Lifeguards *

Yes
No Lifeguards (not required)
No Lifeguards (required) * * * A recommendation is required for this response

Is Lifesaving equipment present *

Yes
No (Recommendation required)

Are pool rules posted *

Yes
No (Recommendation required)

Are there depth markings on the SIDE of the pool *

Yes
No (Recommendation required)

What is the pool depth in Feet and Inches (Feet) *

(Inches) *

Are there any diving boards more than 3 feet high *

Yes (Recommendation required)
No

Is there a sliding board *

Yes (Recommendation required)
No

Are all pool, whirlpool and spa drains VGBA compliant *

Yes
No (Recommendation required)

Are there any tripping hazards *

Yes (Recommendation required)
No

Are there any memberships outside the Association *

Yes
No

What is the size of the pool *

Are there any deficiencies in the pool and/or spa ? *

Yes
No

Describe pool and / or spa deficiencies *

Is there a clubhouse, pool house or other type of recreational building(s) *

Yes
No

Describe use and list the gross area for each in the area table *

Is there a health club or fitness center *

Yes
No

Describe equipment and any outside memberships, trainers or other deficiencies *

Are there any playgrounds, tot lots, sports courts, golf courses or other recreational areas *

Yes
No

List each piece of playground equipment *

Do any deficiencies exist *

Deficiencies exist
No deficiencies exist

Describe equipment and any hazards noted with the equipment or surfacing material *

Are there any lakes, ponds, dams, detention/retention basins, rivers or beaches under association control *

Yes
No

Describe the number of each, any recreational uses permitted and how exposures are controlled *

Does the association have any exposure to alcohol, archery / firearms, daycare, equestrian activities, healthcare / medical, sponsored athletics or trap / skeet shooting *

Yes
No

Describe in detail and association responsibility *

Environmental Coverage: Prior Land Use

Describe prior land use *

Environmental Coverage: Tanks

Are there any aboveground (AST) or underground (UST) storage tanks on the property *

Yes
No

Enter the number of AST *

Enter the number of UST *

Is any secondary containment provided *

Yes
No

Provide the number of each and describe age, contents, UL Listings, tank capacity and any secondary containment provided. This includes plastic tanks that contain pool sanitizers *

Do any of the following deficiencies exist (Evidence of Leaks, No stanchions (AST), Not UL Listed, No tightness test) *

Yes
No

Is there any evidence of leaks *

Yes
No

Do any AST have No stanchions *

Yes there is a deficiency (AST with no stanchions)
No there aren't any AST lacking stanchions

Are there any tanks that are Not UL listed? *

Not UL listed
All tanks are UL listed

Are there tanks with No tightness test *

No tightness test
Tanks have been tightness tested

Describe deficiency, If UGST, provide date of last tightness test and any problems found *

Environmental Coverage: Wells and Septic Systems

Are there any wells on the property that are maintained by the association *

Yes
No

Describe system, any deficiencies and any special protection *

Is well water provided for the Units *

Yes
No

Is well water provided for Common buildings *

Yes
No

Is well water provided for an Irrigation system *

Yes
No

Is well water provided for Fire suppression *

Yes
No

Is well water provided for any Other use *

Yes
No

Describe Other use *

Are there any septic systems on the property that are maintained by the association *

Yes
No

Does the septic system take water from Common buildings *

Yes
No

Does the septic system take water from Units *

Yes
No

Does the septic system take water from 3rd parties *

Yes
No

Does the septic system take water from any Other sources *

Yes
No

Describe Other *

Describe deficiencies and any special protection *

Environmental Coverage: Water and Sewer Treatment

Are there any water treatment facilities maintained by the association on the property *

Yes
No

Is water sold to 3rd parties *

Yes
No

Is the water treatment facility operated by an independent contractor *

Yes
No

Are there annual outside inspections of the water treatment facility *

Yes
No

Is the water treatment facility adequately secured *

Yes
No

Describe system, any deficiencies and any special protection *

Are there any sewage treatment facilities maintained by the association on the property *

Yes
No

Does the sewer treatment facility receive 3rd party waste *

Yes
No

Is the average daily flow greater than 500,000 gallons *

Yes
No

Are there pump alarms *

Yes
No

Is there a generator *

Yes
No

Describe system, any deficiencies and any special protection *

Environmental Coverage: Hazardous Substances

Does the association store any pesticides, herbicides, paints, solvents, cleaning fluids pool chemicals or other chemicals *

Yes
No

What is the combined total gallons stored *

50 gallons or less
More than 50 gallons aggregate

Is there any improper storage, handling, or use *

Yes (Recommendation Required)
No

Describe chemicals, how stored, any deficiencies and any special protection *

Are any pesticides, herbicides or fertilizers applied to the property *

Yes
No

Are pesticides, herbicides or fertilizers applied to the property by licensed applicators and handlers *

Yes
No

Are pesticides, herbicides or fertilizers applied to the property by a Landscaper *

Yes
No

Are pesticides, herbicides or fertilizers applied to the property by the Management Company *

Yes
No

Are pesticides, herbicides or fertilizers applied to the property by an Association Employee *

Yes
No

Is the public warned *

Yes public is warned
No the public is not warned

Are there any environmentally sensitive features on or within 500 feet of the property *

Yes
No

Describe handling of landscaping chemicals *

Is there any pollution at Neighboring exposures within 1000 feet of the Insured's property *

Yes
No

Describe neighboring exposures pollution *

Was there any evidence of mold observed *

Yes
No

Describe evidence of mold *

Were any buildings built prior to 1989 *

Yes
No

In buildings built prior to 1989, has there been any testing for, or remediation of, asbestos containing material *

Yes
No

Describe results/remediation and any remaining asbestos material *

Were any buildings built prior to 1978 *

Yes
No

In buildings built prior to 1978, has there been any testing for, or remediation of, lead paint *

Yes
No

Describe results/remediation *

Loss History

Have there been prior losses *

Yes
No

Discuss trends and any corrective measures implemented *

Is there a significant history of any loss causes *

Yes
No

Check all loss causes having significant history *

Water damage
Ice damming
Frozen pipes or sprinkler lines
Wind
Fire
Slip and Fall
Other liability

Briefly list or describe the other liability *

If any of the above causes are checked, discuss trends and corrective measures implemented here *

Recommendations

Are there any outstanding or prior recommendations *

Yes
No

What is the current status of prior recommendations *

All completed
Partially completed
Not completed

Discuss rec status, and timetables and plans for completion *

Are there any new recommendations as a result of this inspection *

Yes
No

You MUST list the full and complete recommendations from the Rec library linked below. *

Opinion of Risk

What is your opinion of this association *

Satisfactory
Satisfactory w/ recommendations
Unsatisfactory

Describe conditions that cause a rating less than satisfactory *

The Opinion of Risk becomes Satisfactory when the recommendation(s) are brought into compliance.
Other Description for Opinion of Risk

Describe ALL OTHER Conditions that Affect Your Opinion of Risk for this Property

RMS Modifiers, Recommendations, and Area Table Files

After you fill out the required files, did you upload the files to the case ATTACH FILES area for this case? *

Yes
No

After you fill out the required RMS file did you upload it to the ATTACH FILES area for this case? *

Yes
No

Why were you unable to attach the RMS Modifiers file? *

No access to Microsoft Excel
Need help completing

Did you include the required Aerial View photograph? *

Yes
No

Please call the H&S office for help completing/attaching the RMS file. The link to the file can be found above. Provide details on why you were unable to attach the required files? *

RMS Modifiers Information

Roof Covering *

Roof Age/Condition *

0 = Unknown
1 = 0-5 years
2 = 6-10 years
3 = 11-years or more
4 = Obvious signs of deterioration and distress

Roof Geometry *

0 = Unknown
1 = Flat roof with parapets
2 = Flat roof without parapets
3 = Hip roof with slope less than or equal to 6:12 (26.5 degrees)
4 = Hip roof with slope greater than 6:12 (26.5 degrees)
5 = Gable roof with slope less than or equal to 6:12 (26.5 degrees)
6 = Gable roof with slope greater than 6:12 (26.5 degrees)
7 = Braced gable roof with slope less than 6:12 (26.5 degrees)
8=Braced gable roof with slope greater than 6:

Roof Anchor *

0 = Unknown
1 = Toe nailing / No anchor
2 = Clips
3 = Single wraps
4 = Double wraps
5 = Structural

Opening Protection *

Cladding Type *

0 = Unknown
1 = Brick veneer
2 = Metal sheathing
3 = Wood
4 = EIFS/Stucco
5 = Impact rated glazing
6 = Glazing not designed for impact with gravel rooftop within 1000 ft
7 = Glazing not designed for impact without gravel rooftop within 1000 ft
8 = Vinyl siding

Cripple Walls *

0 = Unknown
1 = No cripple walls
2 = Braced cripple walls
3 = Unbraced cripple walls

Frame Bolted to Foundation *

0 = Unknown
1 = Bolted
2 = Unbolted

Soft Story *

0 = Unknown
1 = No
2 = Yes

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CAU-Initial Inspection Form Part 2 v3.0

Property Coverage: Exposures: Special Hazards

Property Coverage: Exposures: Wildfire

Liability Coverage: Slip Trip Fall

Liability Coverage: Life Safety

Liability Coverage: Recreational Facilities

CAU Pool requirements

Environmental Coverage: Prior Land Use

Environmental Coverage: Tanks

Environmental Coverage: Wells and Septic Systems

Environmental Coverage: Water and Sewer Treatment

Environmental Coverage: Hazardous Substances

Loss History

Recommendations

Opinion of Risk

RMS Modifiers, Recommendations, and Area Table Files

RMS Modifiers Information

Form Properties

Field Properties -