Make changes to your existing insurance policies with the AWOIP QUICK CHANGE FORM below. Any change in ownership will require speaking to a representative of AWOIP and may not be completed by using the QUICK CHANGE FORM.
Mailing Address Physical Address
Insured Name:* Policy Number:
Address of premises to be removed Street: City: Zip: Telephone Number:
Address of premises to be added Street: City: Zip: Telephone Number:
Amount of Coverage Building Limit: Contents Limit: Business interruption Limit: Extra Expense Limit:
What is the construction: Is a fire hydrant within 1000 feet? Is a fire company within 3 miles? Is there a sprinkler system? Do you have a fire alarm? Is Fire alarm to central station? What is square foot of building? How many stories is the building? What year was building built? Are there any other occupants?
Is the building owner occuppied? What is the Cupancy of the Building?
Name: Street: City: State: --Select One-- Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington,D.C. Washington West Virginia Wisconsin Wyoming Zip: Telephone Number: Fax Number: Contact: