BLUE SKY INSURANCE AGENCY, INC.     "WHERE THE SKY IS THE LIMIT FOR OUR CLIENTS"                      LICENSE # OD94590

Apartment Building Owner & Owners Insurance Quote First & Last Name:   Location Street Address:   City, State & Zip:   E-Mail Address:   Telephone:   Fax:   Business Name:   Insurance Company Name:   Policy Exp. Date:   Any Claims in Last 3 years?   (if Yes, please describe) Do you carry work comp for your managers?   Yes No Year Property Built:   Any Updates to Property?   (if Yes, please describe) Complete Lender Info.   i.e. Escrow Info if new purchase Apartment Information Apartment Units:   How many Stories?: # of buildings:   Flood Insurance?   Yes No Any Pools?   Yes No Construction Type:   Total Sq. Ft. of building (s):   Earthquake Insurance?   Yes No (if Yes, what type of parking?)   Please give any additional information that might be helpful in providing you an accurate apartment owners insurance quote: Blue Sky Insurance Agency, Inc. Toll Free: 800-300-6188 Phone: 805-578-3883 Fax: 805-582-6191 2775 Tapo St. Ste 102, Simi Valley,California  93063