Insurance Disclosure Statement for Homeowner Association
_______________________Association
Date Prepared:_____________________
(As required by California Civil Code)
Following is a summary of the association property, general liability, earthquake, flood and fidelity insurance polices:
Following is a summary of the association; property, general liability, earthquake, flood, and fidelity insurance polices:
1. Property Coverage:
(A) The name of the insurer __________
(B) The policy limits of the insurance $ __________
(C) The amount of deductible if any: $ __________
(D) The policy term is __________ through __________
2. Liability Insurance:
(A) The name of the insurer:__________
(B) The policy limits of the insurance $ __________
(C) The amount of deductible if any: $ __________
(D) The policy term is__________ through __________
3. Earthquake Insurance:
(A) The name of the insurer:__________
(B) The policy limits of the insurance $ __________
(C) The amount of deductible if any: $ __________
(D) The policy term is __________ through __________
4. Flood Insurance:
(A) The name of the insurer: __________
(B) The policy limits of the insurance $ __________
(C) The amount of deductible if any: $ __________
(D) The policy term is __________through__________
5. Directors and Officers Liability Insurance:
(A) The name of the insurer: __________
(B) The policy limits of the insurance $ __________
(C) The amount of deductible if any: $ __________
(D) The policy term is __________through__________
6. Fidelity Bond Insurance:
(A) The name of the insurer: __________
(B) The policy limits of the insurance $ __________
(C) The amount of deductible if any: $ __________
(D) The policy term is __________through__________
7. Workers' Compensation Insurance:
(A) The name of the insurer: __________
(B) The policy limits of the insurance $ __________
(C) The amount of deductible if any: $ __________
(D) The policy term is __________through__________
This summary is to be distributed to all owners not less then 30 days nor more than 90 days prior to the beginning of an association's fiscal year.
OTC Insurance Services
a California Corporation
5737 Kanan Road, Suite 630
Agoura Hills, CA 91301
Isaac Ortiz 818-429-8022 (Direct)
Office: 818-658-1500
CAInsuranceAgents.com
License # 3013582
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