	Protect Yourself From The Unexpected!	Storage Business Owners Alliance - Tenant Insurance 14435 N 7th St, Suite 101 · Phoenix, AZ 85022 · USA Phone (888) 288-9148 · Fax (888) 506-7087 Call Toll Free (888) 288-9148

Enrollment Application

Take advantage of the savings and benefits by enrolling for SBOA Tenant Insurance today!

SBOA Tenant Insurance Facility Enrollment Form

Company Name*

Street Address*

City*

State / Postal*

Phone1*

()

ext

Fax

()

Company Web Site

http://

Organization Type

Primary
Contact

Your Name*

Title

Cell Phone

Email*

Tell Us About Your Facility

Buildings On Premises

Total # of Buildings
Storage
Non-Storage

Constructions Material

Exterior Walls
Joisting
Roof

Year
Constructed

Total
Square Feet

# of Stories

# of Units

# of Open
Lot Spaces

% Climate
Controlled

Activity

Please describe ANY non-storage activities being conducted by ANY tenants at this location:

Does the Insured have ANY business activities other than Self-Storage at this location?

Questions

Rental Office On Site?

Guard Dogs?

Designed Originally For Self-Storage?

Manual Sign In – Sign Out System?

Operational Fire Sprinkler System?

Gate Access or Control System?

Fire Alarms?
Connected to Central Station?

Are Gates Locked at Night?
Locked Manually

Burglar Alarms?
Connected to Central Station?

Automated Barrier Arm
Sliding Gate

Does Manager Reside on Premises?

Keyboard Touchpad

Fully Lighted at Night?

Card Entry?

Is Facility Fully Fenced or Enclosed?

Driveway Bell?

More Than One Entry, Exit?

TV Monitors?
Security Cameras

LOSS EXPERIENCE (Last 3 Years):

# of
Claims
(Last 3 Years)

Water

Fire

Theft

Vandalism

Please enter this
validation code

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I certify that the manager of this facility will be instructed to hand out a tenant insurance brochure/application and review the Tenant Responsibility Addendum with the customer at the time any lease is signed. I further certify that the manager of this facility will be instructed to explain to new customers the following three conditions:
1) Facility is not responsible for the loss of or damage to customer’s property.
2) Facility does not provide insurance on customer’s property.
3) Customer may obtain insurance under this optional program.

NOTICE TO APPLICANT: I HEREBY DECLARE TO THE BEST OF MY KNOWLEDGE AND BELIEF THAT ALL OF THE FOREGOING STATEMENTS ARE TRUE AND THESE STATEMENTS ARE OFFERED AS AN INDUCEMENTTO THE COMPANY TO QUOTE/ISSUE THE POLICY FOR WHICH I AM APPLYING.

Storage Business Owners Alliance - Tenant Insurance
14435 N 7th St, Suite 101
Phoenix, AZ 85022 USA
www.sboati.com

Toll Free:	(888) 288-9148
Phone:	(888) 288-9148
Fax:	(888) 506-7087

The Storage Business Owners Alliance, LLC (“SBOA”) Tenant Insurance program is offered by Cornerstone Agency Services, LLC (“Cornerstone,” California License CA0H87073) and it is not currently available in all states. A limited insurance license may be required in some states. All questions related to the SBOA Tenant Insurance program should be directed to Cornerstone at 888-288-9148.