Abbreviated Inspection Format

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

GENERAL INFORMATION

• Policy Number

• Name of Insured

• Date and Time of Inspection

  Date
• Address of Inspection
  Address

• Inspection Contact

• Title

• Name of Inspector

BUILDING INFORMATION

• Overall Construction

  Select Frame Masonry Non-Combustible Masonry Non-Combustible Modified Fire Resistive Fire Resistive

  • Frame
  • Masonry
  • Non-Combustible
  • Masonry Non-Combustible
  • Modified Fire Resistive
  • Fire Resistive

• Height

• Age

• Square Feet (building)

• Basement

• Automatic Sprinkler System

  Yes

  No

  N/A

• Electric

  Satisfactory

  Unsatisfactory

  N/A

• Comment

• Plumbing

  Satisfactory

  Unsatisfactory

  N/A

• Comment

• Heating

  Satisfactory

  Unsatisfactory

  N/A

• Comment

• Air Conditioning

  Satisfactory

  Unsatisfactory

  N/A

• Comment

• Liability Exterior

  Satisfactory

  Unsatisfactory

  N/A

• Comment

• Liability Interior

  Satisfactory

  Unsatisfactory

  N/A

• Comment

• Exterior Exposures

  Satisfactory

  Unsatisfactory

  N/A

• Comment

• Fire Alarm

  Yes

  No

  N/A

• Local

  Central

• Burglar Alarm

  Yes

  No

  N/A

• Company Name

• Total # of Employees

• Max # of Employees in Building at One Time

• Description of Insured Occupancy/Operations and Overall Use of Building (NARRATIVE)

• Losses 3 Years?

  Yes

  No

  N/A

• Comment

• Recommendations

  Yes

  No

  N/A

• Comment

• Add any photos taken during inspection here

  Media

• Signature of Inspector

  Sign