Property Coverage Change Request

Skip to content

File a Claim / Incident
- Auto Accident Claims / Incidents
- All Other Claims / Incidents
Policy Requests / Changes
Visit AHRP

File a Claim / Incident
- Auto Accident Claims / Incidents
- All Other Claims / Incidents
Policy Requests / Changes
Visit AHRP

Visit ARHP

HARRP
Coverages
- For Public Housing Authorities
- HARRP Coverage Agreement
Resources
Annual Reports
Contact

HARRP
Coverages
- For Public Housing Authorities
- HARRP Coverage Agreement
Resources
Annual Reports
Contact

Property Coverage Change

Change Property Coverage

NOTE: Due to the complexity of this form and need to upload documents, you may find it easier to input this information on a desktop computer or a larger screen.

Step 1 of 4

25%

Email
This field is for validation purposes and should be left unchanged.
Housing Authority or Insured Entity*
Housing Authority or Insured Entity Address*
Street Address Address Line 2 City State ZIP Code
Your name*
First Last
Your email*
Phone*
Location Information
Location name
Tax ID*
Location address*
Street Address Address Line 2 City State ZIP Code
Property Manager*
If the Property Manager is not the housing authority, please attach certificates and the property management agreement (upload available at end of form).
Does the contract property manager have Errors & Omissions / Tenant Discrimination insurance?*
- YES
- NO
Is the property manager or contracted party(ies) contractually responsible for fair housing claims?*
- YES
- NO
Entity Information
Type of Entity*
- Wholly owned by housing authority
- Limited liability company or partnership (general or limited) that provides affordable housing and is affiliated* with a housing authority or nonprofit corporation that provides affordable housing
- Non-profit corporation
*Affiliated means (i) an ownership interest by the housing authority or nonprofit corporation in the partnership or LLC, (ii) the right of the housing authority or nonprofit corporation to direct management or policies of the partnership or LLC or (iii) a contract for the housing authority or nonprofit corporation to lease, manage or operate the affordable housing.
What activities other than housing is the owner involved in?*
Are you seeking insurance for these other activities?*
- YES
- NO
If a non-profit corporation, do the nonprofit and the housing authority have the same board of directors?*
- YES
- NO
Type of Unit(s)
- Senior
- Family
- HOA / Condo
- Single-Room-Occupancy
- Group Home
- Assisted Living / Disabled
- Supportive Housing
- Other
Please describe services*
Insurance Information
Policies Requested*
- Liability & Property
- Liability Only
- Liability Only (During Construction)
- Property only
Proposed effective date*
Current deductible*
General liability limits*
Excess*

Building / Structure Information
Building*
Street Address Address Line 2 City State ZIP Code
Year built*
# of Stories*
# of Dwelling Units*
# of Non-dwelling Units*
Building Sq Ft.*
Building Structure Value*
Building Contents Value*
Annual Building Rents*

Total structure value*
Value per square foot*
Dwelling type*
- Apartments
- Condos
- Duplex
- Triplex
Are there NON-cosmetic repairs needed?*
- YES
- NO
Describe non-cosmetic repairs that are necessary:
Is the structure currently occupied?*
- YES
- NO
Is the property on historical register?*
- YES
- NO
Construction Type*
- Wood
- Fire Resistant
- Joisted Masonry
Roof Type*
- Composit
- Metal
- Clay / Concrete Tiles
- Asphalt Shingles
- Stone-coated Steel
- Slate
- Rubber Slate
- Green Roof
- Built-up Roofing
Roof last update (year)*
Electrical last update (year)*
Plumbing last update (year)*
Heating last update (year)*
Electrical Panel Box*
- Fuses
- Circuit Breakers
Smoke detectors?*
- YES
- NO
Sprinklers?*
- YES
- NO
Fire alarms?*
- YES
- NO
Monitored?*
- YES
- NO
Does each unit have its own breaker/fuse box?*
- YES
- NO
Management on site?*
- YES
- NO
Maintenance equipment or buildings on site?*
- YES
- NO
Playground?*
- YES
- NO
Workout room?*
- YES
- NO
If YES, are signs posted (i.e. “Use equipment at your own risk”)?
- YES
- NO
Swimming pool?**
- YES
- NO
If YES, does it have a 6’ fence & self-closing & latching gates?
- YES
- NO
Are solar panels at this location?*
- YES
- NO
If YES, what is the value?

Organizational Information
Have Fair Housing complaints, claims/orders been filed against the entity?*
- YES
- NO
Have building inspectors, the fire department, or a municipality issued building or life safety code violations, citations, or orders against the property?*
- YES
- NO
When was the last fair housing training for all staff?
Do you provide security services?*
- YES
- NO
If YES, what type?
Are any employees required to carry a special license of any kind?*
- YES
- NO
If YES, what type?
Attach photographs of the Building/Property
If there are any supporting photographs of the building interior or exterior, please attach. (supported formats: .jpg, .jpeg, .png, .hei; 12MB max per photo)
Drop files here or

Accepted file types: jpg, jpeg, png, heic, Max. file size: 12 MB, Max. files: 25.
Attach supporting documents
If there are any supporting documents, please attach. (supported formats: .doc, .docx, .pdf)
Drop files here or

Accepted file types: doc, docx, pdf, Max. file size: 128 MB.
ELECTRONIC SIGNATURE*
- I certify that the information on the application is true and accurate to the best of my knowledge. I understand that if alternate information becomes available, it may result in a change of premium or policy/coverage cancellation. By submitting I am providing my electronic signature.

Questions?

For questions about property coverage changes, contact the representative assigned to your organization, based on the first letter of your member or affiliate member name.

Names beginning A–N

Jen Polanco

(360) 574-9384

Names beginning O–Z

Meaghan Brown

(360)718-5699

Quick Links

File a Claim/Incident
Proof of Coverage Request
Property Coverage Change
Auto Coverage Change
Bare Land Request
Underwriting Questionnaire

Coverages

HARRP: Insurance for Public Housing Authorities
AHRP: Insurance for Affordable Housing Providers

Member Resources

Training
Safety
Contract Templates
Consulting Services
Archived Newsletters
Subscribe to Loss Mitigation Newsletter

About Us

HARRP Overview
AHRP Overview
HARRP Leadership & BOD
AHRP BOD
HARRP Members
Contact Us
Employment Opportunities

Built by branding agency, OVO.

Property Coverage Change

Change Property Coverage

Step 1 of 4

Location Information

Entity Information

Insurance Information

Building / Structure Information

Organizational Information

Questions?

For questions about property coverage changes, contact the representative assigned to your organization, based on the first letter of your member or affiliate member name.

Names beginning A–N

Jen Polanco

Names beginning O–Z

Meaghan Brown