Application for Stateside APM Hazard & Liability insurance bulk billing program.

ALL fields must be completed.

Applicant Details

Properties covered by this application

This is a 'bulk application' details of the properties covered are contained in the attached spreadsheet.

Property Manager Details

US Bank Account Details For ACH Collection


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

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 maybe adjusted.

3. I further agree that it is solely my responsibility as the property manager of these property to ensure that the owner is fully aware of the policy terms and conditions and agree to hold harmless Stateside APM should I fail to do so.

4. I/We understand that Full Terms & Conditions are available online at and agree to ensure that I will pass this on to the owner of every property that I add to this application.

5. I/We understand that the coverage offered by the Stateside APM programs does not replace E&O or General Liability insurance that my business should carry. I/We further agree to hold harmless Stateside APM from any action arising out of our negligence as a property manager.
6. I/We understand it is our responsibility to notify Stateside APM of any change in property management and any change in occupancy status within 48 hours.

7. New properties may be added at any time, by notifying Stateside APM using it’s agreed procedures.

8. Policies may be cancelled at any time by notifying Stateside APM using it’s agreed procedures and a prorated amount of any premium paid will be refunded.

9. I/We understand that vacant properties must be inspected at least on a monthly basis and secured in a manner suitable for the area they are situated. Failure to do so may affect cover and invalidate any claim.

10. Proof of value may be required for sums insured of $150,000 and above.

11. I/We authorize Stateside APM to collect payment for the selected options monthly by ACH from our nominated account. I/We understand that payments by any other method may attract additional fees.

12. I/We understand there is a $25 one-time setup fee applied to each property, for each product selected.

13. Applications take 48 hours to process. Expedited service may be requested for an additional fee, but agree to hold harmless Stateside APM for any delay howsoever caused.

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

15. If payment is not received by the date due the policy will be cancelled from the dates of the last premium payment received.

16. Where cover has been requested we agree to pay all premiums, setup and admin fees for the period cover is required.

17. I/We understand that Stateside APM’s master policies are monthly policies and 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 cancel and receive a prorated refund of premiums paid

18. All policies will commence from the Start Date indicated on this form unless we are notified in writing 48 hours in advance.

19. Start dates cannot be earlier than the application date.

20. I/We agree and understand that Stateside APM cannot give and has not, given any advice as to the amount of insurance that I/we should purchase or to the suitability of the cover provided and agree that this is solely my/our responsibility. I/we further understand that Stateside APM is NOT an insurance agency and that they cannot advise on or procure any individual insurance policy for me.

21. Full details of the policy terms and conditions and claims procedures, together with any additional terms and conditions imposed by Stateside APM are available at

22. 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.