BI Short App – Stateside APM Portal

Administrative Property Management including Building hazard & liability insurance programs option

Please provide your name, where you live, your email and phone number,

Please submit a separate form for each LLC you own.

First Name *

Last Name *

Email Address *

Phone Number *

Preferred language *

Street ( house number & road name) *

City *

County / State

Postal Code / ZIP *

Country *

Terms & Conditions

1.	I/We agree & understand that I am contracting with Stateside APM to provide Administrative Property Management Services which include the option to add my property to Stateside APM' master insurance policies. The costs of which will be itemized on each invoice which it is my responsibility to read and check..

2.	I/We have read, understand and accept the Building & Liability Insurance and/or Home Warranty policy terms & conditions & agree to hold harmless Stateside APM with regard to the suitability of the policy for my purpose, the amount of cover I choose or how claims may be adjusted. 

3.	I/we understand that Stateside APM is NOT an insurance agency and that they cannot advise on or procure any individual insurance policy for me.

4.	I/We understand that Stateside APM’s master policies are monthly policies and that if I pay for 12 months in advance it does not guarantee the premium will not change during that period. Should the premium change, I understand I will have the option to continue and pay the additional cost, or remove my property and receive a prorated refund of premiums paid. 

5.	I/We understand it is our responsibility to notify Stateside APM of any change in property management or ownership. 

6.	I/We understand it is our responsibility to notify Stateside APM of any change in occupancy status within 48 hours and that that vacant properties must be inspected in accordance with the conditions of the program the property has been added to and secured in a manner suitable for the area they are situated. Failure to do so may affect cover and invalidate any claim. 

7.	I/We understand that in the event of a claim we will be required to submit photos of the property showing the condition before and after the incident. Together with a quote to repair the damage caused by the incident. 

8.	I/We agree to adhere to Stateside APM claim procedures and understand that failure to provide the information requested may hinder or invalidate any claim. Details of our claim procedure and policy documents for all of our programs can be found on our website at portal.statesideapm.com/iptc

9.	Proof of value may be required.

10.	I/We authorize Stateside APM to collect payment for the selected options and understand No cover will commence until payment is received. 

11.	I/We understand there is a $39 one-time setup fee applied to each property insured, for each product selected. 

12.	Applications take 72 hours to process. Expedited service may be requested for an additional fee, but agree to hold harmless Stateside APM for any delay howsoever caused.  I/We further understand a Change fee of $39 per property will be applied for changes of program or payment frequency.

13.	I/We agree that regular monthly payments will be made by ACH collection, I/We understand that payments by any other method will attract an additional monthly processing fee per property. 

14.	Payments by credit or debit card attract a 3.75% convenience fee. Payments by wire transfer attract an additional $25 processing fee.

15.	Any payments not received by the due dates will result in the cancellation of the policy from the date of the last premium payment received. If service is recommenced a reinstatement fee of $39 per property will be applied. Cover may be cancelled at any time and a prorated amount of any premium paid will be refunded. 

16.	All cover will commence from the Start Date indicated on this form unless we are notified in writing 48 hours in advance. Start dates cannot be earlier than the application date. 

17.	These Terms and Conditions supersede all previous Terms and Conditions and are in addition to the policy terms & conditions. By submitting this application, I agree to be bound by the policy terms and conditions of Stateside APM and its insurance carriers. Full terms & conditions can be found at portal.statesideapm.com/tc

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All the properties below are owned by *

Payment Frequency *

Monthly

Annually

You can change this at a later date, but selecting an option now will enable us to provide actual costs quicker.

Properties

Owner

Street *

enter the street address

City *

enter the city name

State *

select the State from the list

ZIP *

enter the 5 digit zip code

Property manager

enter the full name of the property manager for this property

Status *

Occupied

Vacant

is it occupied or vacant?

Sum Insured *

how much do you want to insure the property for

Add Remove

T&C acceptance *

I accept these terms & conditions

Date

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