Name: Preferred Insurance
Address: 4035 Ridge Top Road, Fairfax, VA, 22030, US
Telephone: (703) 359-5910

Business Name
Contact Name
First Last
Contact Phone
Contact Email
Location Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Estimated Start Date
MM slash DD slash YYYY
Estimated Completion Date
MM slash DD slash YYYY
Intended Occupancy
Distance To Fire Hydrant
Distance To Fire Department
Building Construction
- Frame
- Masonry
- Masonry Non-Combustible
- Metal
New Construction Insurance Value Excluding Land ("Sticks & Bricks")
Desired Deductible
- $500
- $1000
- $2500
100% Replacement Cost (Included)
Completed Value, Cost of Repair/Replacement, Labor, Reasonable Overhead and Profit, Delivery Charge and Excludes Land.
Soft Code Digit & Rental Income ($50,000 included; recommend 10% of structure value)
Disclaimer: Communications to this insurance agency by electronic mail or voice mail CANNOT be considered as binding or otherwise effective for ANY insurance protection/policy coverage. Our office will contact you via e-mail to confirm any information sent and please look for the policy change endorsement to follow. If you do not receive this endorsement from the insurance carrier, contact your agent immediately. Thank you.
Attachments
Max. file size: 59 MB.

Builder’s Risk Change Request

100% Replacement Cost (Included)