Powderhorn Agency - Mobile Home Community Program Application

YOUR SOURCE FOR HOME SYSTEMS PROTECTION - SPECIALIZING IN OIL TANKS, SEPTIC SYSTEMS AND COMPLETE HOME WARRANTIES

Mobile Home Community Program Application

Management Company Name *
Contact Name *
Address *
City *
State *
Zip *
Telephone Number *
Fax Number
Email Address *
Web Address
Number of Properties Applicable *
When would you like to make ProGuard effective on your properties? *
Will you be including ProGuard into your lease agreements? *	Yes No
If yes, when do your leases renew?
List the name and address of each community being covered and the number of oil tanks in each location:
Do you currently or have you ever offered a tank protection program? *	Yes No
If yes, name(s) of program(s) and number of customers enrolled:
How did you hear about ProGuard? *
Are you a member of a state/local mobile home community association? *
If so, which one(s)?
Are any properties rent stabilized or retirement communities? *	Yes No
Who is your insurance agent for your property & casualty coverage? *