{"title":"Course of Construction Questionnaire","description":"Please provide details about the property, planned construction, security, and contractor.","showQuestionNumbers":"onPage","questionErrorLocation":"bottom","checkErrorsMode":"onNextPage","completedHtml":"

Thank you — your questionnaire is in.

Susman Insurance Agency has received your Course of Construction information. Please look for a response within 24-48 hours.

","pages":[{"name":"owner_name","elements":[{"type":"text","name":"owner_name","title":"Name of owner","isRequired":true}]},{"name":"date_of_birth","elements":[{"type":"text","inputType":"text","name":"date_of_birth","title":"Date of birth","isRequired":true,"maskType":"datetime","maskSettings":{"pattern":"mm/dd/yyyy","saveMaskedValue":false},"placeholder":"MM/DD/YYYY","description":"Use Month/Day/Year (MM/DD/YYYY)."}]},{"name":"phone","elements":[{"type":"text","inputType":"tel","name":"phone","title":"Phone","autoComplete":"tel","isRequired":true}]},{"name":"email","elements":[{"type":"text","inputType":"email","name":"email","title":"Email","autoComplete":"email","isRequired":true}]},{"name":"occupation","elements":[{"type":"text","name":"occupation","title":"Occupation","isRequired":true}]},{"name":"how_found_us","elements":[{"type":"radiogroup","name":"how_found_us","title":"How did you find us?","choices":["Search engines","Social media","News story","Referral","I am a current client of Susman Insurance"],"isRequired":true}]},{"name":"referral_name","elements":[{"type":"text","name":"referral_name","title":"Name of referral","visibleIf":"{how_found_us} = 'Referral'","isRequired":true}]},{"name":"marital_status","elements":[{"type":"dropdown","name":"marital_status","title":"Marital status","choices":["Single","Married","Divorced","Widowed"],"isRequired":true}]},{"name":"spouse_name","elements":[{"type":"text","name":"spouse_name","title":"Spouse name","visibleIf":"{marital_status} = 'Married'","isRequired":true}]},{"name":"mailing_address","title":"Mailing address","elements":[{"type":"text","name":"mailing_address__address","title":"Street address","autoComplete":"address-line1","isRequired":true},{"type":"text","name":"mailing_address__address_line_2","title":"Address line 2","autoComplete":"address-line2","isRequired":false},{"type":"text","name":"mailing_address__city","title":"City","autoComplete":"address-level2","isRequired":true},{"type":"text","name":"mailing_address__state","title":"State","autoComplete":"address-level1","isRequired":true},{"type":"text","name":"mailing_address__zip_code","title":"ZIP code","autoComplete":"postal-code","isRequired":true}]},{"name":"property_address","title":"Property address of construction","elements":[{"type":"text","name":"property_address__address","title":"Street address","autoComplete":"address-line1","isRequired":true},{"type":"text","name":"property_address__address_line_2","title":"Address line 2","autoComplete":"address-line2","isRequired":false},{"type":"text","name":"property_address__city","title":"City","autoComplete":"address-level2","isRequired":true},{"type":"text","name":"property_address__state","title":"State","autoComplete":"address-level1","isRequired":true},{"type":"text","name":"property_address__zip_code","title":"ZIP code","autoComplete":"postal-code","isRequired":true}]},{"name":"purchase_date","elements":[{"type":"text","inputType":"text","name":"purchase_date","title":"Purchase date of property","isRequired":true,"maskType":"datetime","maskSettings":{"pattern":"mm/dd/yyyy","saveMaskedValue":false},"placeholder":"MM/DD/YYYY","description":"Use Month/Day/Year (MM/DD/YYYY)."}]},{"name":"purchase_price","elements":[{"type":"text","inputType":"number","name":"purchase_price","title":"Purchase price","description":"Enter the amount in dollars.","min":0,"step":1,"isRequired":true}]},{"name":"property_square_footage","elements":[{"type":"text","inputType":"number","name":"property_square_footage","title":"Square footage of property","min":1,"step":1,"isRequired":true}]},{"name":"square_footage_addition","elements":[{"type":"radiogroup","name":"square_footage_addition","title":"Will there be an addition to the property's square footage?","choices":["Yes","No"],"isRequired":true}]},{"name":"additional_square_footage","elements":[{"type":"text","inputType":"number","name":"additional_square_footage","title":"How many square feet will be added?","min":1,"step":1,"visibleIf":"{square_footage_addition} = 'Yes'","isRequired":true}]},{"name":"has_basement","elements":[{"type":"radiogroup","name":"has_basement","title":"Is there a basement?","choices":["Yes","No"],"isRequired":true}]},{"name":"basement_square_footage","elements":[{"type":"text","inputType":"number","name":"basement_square_footage","title":"How many square feet is the basement?","min":1,"step":1,"visibleIf":"{has_basement} = 'Yes'","isRequired":true}]},{"name":"work_description","elements":[{"type":"comment","name":"work_description","title":"Description of work to be done","rows":5,"isRequired":true}]},{"name":"estimated_job_cost","elements":[{"type":"text","inputType":"number","name":"estimated_job_cost","title":"Estimated cost of job","description":"Enter the amount in dollars.","min":0,"step":1,"isRequired":true}]},{"name":"estimated_job_length","elements":[{"type":"text","name":"estimated_job_length","title":"Estimated length of job","placeholder":"For example: 6 months","isRequired":true}]},{"name":"intended_occupancy","elements":[{"type":"dropdown","name":"intended_occupancy","title":"Intended occupancy upon completion","choices":["Primary home","Secondary home","Rental property","Vacant or for sale"],"showOtherItem":true,"otherText":"Other","isRequired":true}]},{"name":"plans_to_sell","elements":[{"type":"radiogroup","name":"plans_to_sell","title":"Do you plan on selling the house?","choices":["Yes","No"],"isRequired":true}]},{"name":"security_heading","title":"Security and protection information","elements":[{"type":"radiogroup","name":"twenty_four_hour_guard","title":"Will there be a 24-hour guard?","choices":["Yes","No"],"isRequired":true}]},{"name":"locked_during_non_working_hours","elements":[{"type":"radiogroup","name":"locked_during_non_working_hours","title":"Will the dwelling be locked and secured during non-working hours?","choices":["Yes","No"],"isRequired":true}]},{"name":"site_fenced_and_lit","elements":[{"type":"radiogroup","name":"site_fenced_and_lit","title":"Will the construction site be fenced and lit?","choices":["Yes","No"],"isRequired":true}]},{"name":"central_station_alarm","elements":[{"type":"radiogroup","name":"central_station_alarm","title":"Is there a working Central Station fire and burglar alarm?","choices":["Yes","No"],"isRequired":true}]},{"name":"additional_security","elements":[{"type":"comment","name":"additional_security","title":"What additional security is available?","description":"For example: guard patrol, a locked structure for building materials, or a watchman. Enter None if there is no additional security.","rows":4,"isRequired":true}]},{"name":"general_contractor_name","elements":[{"type":"text","name":"general_contractor_name","title":"Name of general contractor","description":"Enter Not selected yet if a contractor has not been chosen.","isRequired":true}]},{"name":"general_contractor_license","elements":[{"type":"text","name":"general_contractor_license","title":"General contractor license number","description":"Enter Not available if a contractor has not been chosen.","isRequired":true}]},{"name":"general_contractor_insurance","elements":[{"type":"comment","name":"general_contractor_insurance","title":"Name of general contractor's insurance carrier and limits","description":"A minimum $1,000,000 coverage limit with Products/Completed Operations coverage is required. Enter the carrier name and limits, or Not available if a contractor has not been chosen.","rows":3,"isRequired":true}]},{"name":"insured_is_builder_developer_contractor","elements":[{"type":"radiogroup","name":"insured_is_builder_developer_contractor","title":"Is the insured a builder, developer, or contractor?","choices":["Yes","No"],"isRequired":true}]},{"name":"builder_developer_contractor_description","elements":[{"type":"comment","name":"builder_developer_contractor_description","title":"Please describe the insured's builder, developer, or contractor activities","rows":4,"visibleIf":"{insured_is_builder_developer_contractor} = 'Yes'","isRequired":true}]},{"name":"subcontractors_hired","elements":[{"type":"radiogroup","name":"subcontractors_hired","title":"Will subcontractors be hired?","choices":["Yes","No"],"visibleIf":"{insured_is_builder_developer_contractor} = 'Yes'","isRequired":true}]},{"name":"subcontractors_licensed","elements":[{"type":"radiogroup","name":"subcontractors_licensed","title":"Are the subcontractors licensed?","choices":["Yes","No"],"visibleIf":"{insured_is_builder_developer_contractor} = 'Yes' and {subcontractors_hired} = 'Yes'","isRequired":true}]},{"name":"subcontractor_insurance_evidence","elements":[{"type":"radiogroup","name":"subcontractor_insurance_evidence","title":"Do you obtain evidence of insurance from subcontractors?","choices":["Yes","No"],"visibleIf":"{insured_is_builder_developer_contractor} = 'Yes' and {subcontractors_hired} = 'Yes'","isRequired":true}]},{"name":"mid_term_project","elements":[{"type":"radiogroup","name":"mid_term_project","title":"Is this a mid-term Course of Construction project?","choices":["Yes","No"],"isRequired":true}]},{"name":"percentage_completed","elements":[{"type":"text","inputType":"number","name":"percentage_completed","title":"What percentage is completed?","description":"Enter a number from 0 to 100.","min":0,"max":100,"step":1,"visibleIf":"{mid_term_project} = 'Yes'","isRequired":true}]},{"name":"rehab_or_renovation","elements":[{"type":"radiogroup","name":"rehab_or_renovation","title":"Is this a rehab or renovation?","choices":["Yes","No"],"isRequired":true}]}]}