Index Research Services Inc.
OL&T – STOREKEEPERS LIABILITYREPORT
F-154e Electronic Format
Insured’s Name:
KULEANA MAUI AOAO / Policy Number(s)GC953890
DBA: / ATTN:
RANELL MANZANO
Survey Location:
3959 LOWER HONOAPIILANI ROAD / ACCT. NO.
1600 / TOTAL CHARGES
LAHAINA, HI 96761 / Agent: ATLAS INSURANCE
Contact Name – Title
RON KOBELY, MANAGER /
Survey Date
08/20/13 /Inspector ID
30023ALL [ q* ] RESPONSES REQUIRE EXPLANATION, APPLICABLE SUPPLEMENTS
AND/OR SUGGESTIONS FOR IMPROVEMENT
All reports are provided in response to your specific request and are for your exclusive use and benefit under permissible purposes as defined by applicable laws and statutes. The information contained herein represents conditions and information available at time of inspection, and the opinions of the on-site inspector; but not based on any laws, codes or regulations. Reports are given only as an aid in evaluating an insurance transaction and represent information from sources available and from conditions visible at time of inspection; the accuracy of this information is in no way guaranteed and in any event, the liability for accuracy shall never exceed the price paid for that report. In purchasing reports, you acknowledge these as the only terms and conditions of service and agree to hold Index Research Services Inc. free and harmless from any liability or damage arising from the transaction.
BUILDING
CONSTRUCTIONS /
CONDITION &
HOUSEKEEPING /ELEVATORS
And/or SIGNS /SWIMMING
POOL /AGE OF
BUILDING /UNUSUAL
HAZARDS / PASTLOSSES
Frame
ConcreteOther /
Good
Remarks* /No
Remarks* /None
FencedRemarks* / 40 Years /
Normal
Remarks* / None LearnedRemarks*
Building No. / Description of Occupant(s) / SQUARE FOOTAGE
Total Area / Public Access Area
Bldg 1 / Condos / 3,881
Bldg 2 / Condos / 4,860
Bldg 3 / Condos / 10,692
Bldg 4 / Condos / 7,776
Bldg 5 / Condos / 7,776
Bldg 6 / Condos / 10,692
Bldg 7 / Condos / 7,776
Bldg 8 / Office / 500
TOTAL SQUARE FOOTAGE: / 97,953
PHYSICAL
Type of Neighborhood?Food served on premises?
Liquor served on premises?
Class of insured’s clientele?
Firearms kept on premises?
Dancing on premises?
Have fire exits posted?
Have fire extinguishers?
Type of Heating System? / Apts.
No
No
Good
No
No
Yes
Yes
Gas / Resid.
Yes
Yes
Rmrks*
Rmrks*
Yes*
No
No
Elect. / Comml.
Other* / If Apartments, number of units?
Average monthly apartment rental?
Transient type tenancy?
Any children in tenancy?
Any playground or recreation area?
Passenger elevators in building?
If YES, permits posted & valid?
Stairwells have fire doors? N/A
Past liability-injury claims learned? / ---
$---
No
No
No
No
Yes
Yes
No / Yes*
Yes*
Yes*
Yes*
No*
No*
Yes*
GOOD / RMKS* / N/A / GOOD / RMKS* / N/A
Fire Escapes & Accessories / Yards and Sidewalks
Fire Protection Equipment / Parking & Delivery Areas
Floor Coverings - Surfaces / Lighting (General)
Stair treads & Lighting / Skylights
Exits & Entrances / Wiring
Aisle & Hall Clearances / Roof Drains
Overhead Clearances / Awnings - Overhangs
Elevation Changes / Signs
Fire Doors / Roof Tanks - Supports
Public Access Areas / Gutters - Downspouts
Balcony-Stair Railings / Heating Units
Stair Handrails / Plate Glass
Copings & Cornices / Ceilings - Walls
Boilers - Pressure Vessels / Porches
Machinery / Swimming Pool
INCLUDE GENERAL LIABILITY NARRATIVE.
INCLUDE DIAGRAM IF REQUIRED.
MAKE APPLICABLE SUGGESTIONS FOR IMPROVEMENT OR HAZARD CORRECTIONS.
Index Research Services Inc.
SWIMMING POOL SUPPLEMENT
S-121e Electronic Format
©opyright 2007
Insured’s Name:
KULEANA MAUI AOAO / Policy Number(s)GC953890
DBA: / ATTN:
RANELL MANZANO
Survey Location:
3959 LOWER HONOAPIILANI ROAD / ACCT. NO.
1600
LAHAINA, HI 96761 / Agent: ATLAS INSURANCE
Contact Name – Title
RON KOBELY, MANAGER /
Survey Date
08/20/13 /Inspector ID
30023ALL [ q* ] RESPONSES REQUIRE EXPLANATION, APPLICABLE SUPPLEMENTS
AND/OR SUGGESTIONS FOR IMPROVEMENT
All reports are provided in response to your specific request and are for your exclusive use and benefit under permissible purposes as defined by applicable laws and statutes. The information contained herein represents conditions and information available at time of inspection, and the opinions of the on-site inspector; but not based on any laws, codes or regulations. Reports are given only as an aid in evaluating an insurance transaction and represent information from sources available and from conditions visible at time of inspection; the accuracy of this information is in no way guaranteed and in any event, the liability for accuracy shall never exceed the price paid for that report. In purchasing reports, you acknowledge these as the only terms and conditions of service and agree to hold Index Research Services Inc. free and harmless from any liability or damage arising from the transaction.
PHYSICAL FEATURES
1. Is pool completely fenced with fence which is at least 6 feet high?(a) If NO, explain:
2. Is pool fence equipped with a self-locking gate?
3. Is gate lock/latch at or near the top of gate, out of children’s reach?
4. Does the pool have depth markings?
5. Does pool have depth separations (ropes, etc.)?
6. Does pool have a ladder to assist in exiting the water?
7. Are pool deck and walking areas of non-slip materials or finish?
8. Is swimming pool area well lighted?
9. Are swimming pool rules clearly posted?
10. Is there a Lifeguard or Pool Supervisor on duty during all hours pool is open?
11. Is swimming pool professionally serviced?
12. Is swimming pool equipped with Anti-Vortex (anti-entrapment cover or drain)?
13. Is there an Automatic Pump Shut Off installed if drain is blocked? / YES / NO / N/A
*
*
*
*
*
*
*
*
DIVING BOARDS – POOL EQUIPMENT
1. Is there a diving board installed?2. Is the diving area separated from other swimming areas?
3. Any pool slide or other activity equipment installed?
(a) Describe:
4. What is the maximum depth of the pool? 7 Feet / YES / NO / N/A
*
* /
ACCIDENTS – CLAIMS
GIVE DETAILS OF PAST SWIMMING POOL ACCIDENTS, INJURIES AND CLAIMS. INCLUDE DATES AND AVAILABLE DETAILSNO PAST CLAIMS OR LOSSES REPORTED
NARRATIVE
BUSINESS & OPERATIONS:
This business operates under the trade name of Kuleana Maui AOAO and is owned and operated by your insured. The insured has been in business for forty years and at this location for forty years. The business appears well established, management is stable and appears to have a good attitude toward loss control. The insured has six employees at this location. There is staff turnover. Financial information was not disclosed.
The operations here consist of a homeowners association with seven buildings. The units are owner occupied and/or vacation rentals. There is also an office building located in building #8.
No unusual hazards appear to be posed by operations, equipment, or materials. Principal equipment used here consists of residential appliances and furnishings along with office equipment. All equipment is well maintained, clean and regularly serviced. Electrically powered equipment uses three prong grounded plugs.
PREMISES/NEIGHBORHOOD:
Buildings #1 and #2 were constructed approximately forty years ago, are two stories in height, with no basement. The building is masonry and wood in construction with wood shake roof coverings, which appeared to be in good condition at the time of our inspection. The wiring is in conduit with circuit breaker protection. There is no heating, however there is central air conditioning. All utilities appeared to be operating properly at the time of our inspection. Updates were not disclosed.
Buildings #3, #4, #5, #6 and #7 were constructed approximately forty years ago, are two stories in height, with no basement. The building is masonry in construction with wood shake roof coverings, which appeared to be in good condition at the time of our inspection. The wiring is in conduit with circuit breaker protection. There is no heating, however there is central air conditioning. All utilities appeared to be operating properly at the time of our inspection. Updates were not disclosed.
Buildings #8 was constructed approximately forty years ago, is one story in height, with no basement. The building is masonry in construction with a wood shake roof covering, which appeared to be in good condition at the time of our inspection. The wiring is in conduit with circuit breaker protection. There is no heating, however there is central air conditioning. All utilities appeared to be operating properly at the time of our inspection. Updates were not disclosed.
There are no apartment units in the building. There are no other businesses on the property. There is one swimming pool. It is completely fenced, with self-locking gate. The fence is six feet tall and is bar type. The lock on the gate is four feet high off the ground. The pool is seven feet deep. There is no diving board.
LIABILITY:
Exits and entrances were in good condition. Plate glass had no cracks or breaks. There is adequate interior and exterior lighting. Signs appear to be properly anchored. Sidewalks had no lifting or cracking of the concrete surfaces. Parking areas had no potholes, depressions, deterioration or oil and grease buildup. Interior floor surfaces are in good condition with no damage noted. There are
some stairs, which are well lighted and have safe sturdy handrails. Steps do have non-slip treads / surfaces.
We noted no trip-and-fall hazards at the time of our inspection. We noted no liability hazards at the time of our inspection. There were no past injury claims or accidents revealed by the insured. There were no guard dogs or firearms on the premises.
LOSSES:
No losses known or reported.
SUGGESTIONS:
We have no suggestions at this time.
DATE: 08/20/13
INTERVIEWED: Ron Kobely, Manager
CPO/30023/kf
1
Index Research Services Inc.
SUGGESTIONS
F-238e
Date: 08/20/13 Policy No.: GC953890
Insured: KULEANA MAUI AOAO
Location: 3959 LOWER HONOAPIILANI ROAD
LAHAINA, HI 96761
Suggestions offered reflect the opinion of the inspector, based on conditions observed or reported at the time of inspection. They are not based on any Codes, Laws or Regulations, and providing suggestions does not warrant that these are the only improvements needed nor that compliance will eliminate prospects of a loss. Suggestions are made for the use and benefit of our customers, and where specific suggestions may vary from your company policy, standards or requirements, you may freely revise, modify or eliminate each.No suggestions at this time.
We make the following suggestions: