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4 Point Inspection Template

The 4-Point Inspection Form is a crucial document used to evaluate the condition of a property's roof, electrical, HVAC, and plumbing systems. This form must be completed by a licensed inspector in Florida, who will assess each system for hazards and deficiencies. To ensure your property meets underwriting requirements, fill out the form by clicking the button below.

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Structure

The 4 Point Inspection Form serves as a crucial tool in assessing the condition of a property for insurance purposes. It focuses on four primary systems: the roof, electrical, HVAC, and plumbing. Each section of the form requires detailed information, including the age and condition of the systems, as well as any visible hazards or deficiencies. For the roof, inspectors must note the predominant covering material, remaining useful life, and any signs of damage or leaks. The electrical section requires documentation of the main panel, including the type of wiring and any remediation for aluminum wiring. Additionally, inspectors evaluate the HVAC system's functionality and maintenance history, while the plumbing section assesses the presence of leaks and the general condition of fixtures. Photographic evidence is also mandated to support the findings, ensuring a comprehensive overview of the property’s systems. A licensed Florida inspector must complete and sign the form, providing assurance that the information is reliable for underwriting decisions.

Instructions on How to Fill Out 4 Point Inspection

Completing the 4 Point Inspection form is an essential step in assessing the condition of a property’s major systems. This process involves gathering specific information about the roof, electrical, HVAC, and plumbing systems to ensure they meet underwriting requirements. Following the steps below will help ensure that the form is filled out accurately and completely.

Start with the basic information: Fill in the Insured/Applicant Name, Application/Policy Number, and Address Inspected at the top of the form.
Document the property's age: Indicate the Actual Year Built and Date Inspected.
Gather required photos: Ensure you have photos for each side of the dwelling, each slope of the roof, and key plumbing and electrical components as specified in the minimum photo requirements.
Complete the electrical system section: Note the type of main and second panels, total amps, and whether the amperage is sufficient. Document any hazards present and provide the general condition of the electrical system.
Fill out the HVAC system details: Indicate whether there is central AC and heat, the age of the system, and if it is in good working order. Include any hazards present and the date of the last HVAC servicing.
Assess the plumbing system: Answer questions about the temperature pressure relief valve and any signs of leaks. Rate the condition of plumbing fixtures and connections.
Evaluate the roof: Describe the predominant roof covering material, roof age, and overall condition. Check for visible signs of damage or leaks and include the date of the last roofing permit.
Provide additional comments: Use the section for any observations, updates, or details regarding hazards or deficiencies noted during the inspection.
Finalize the form: The inspector must sign, date, and provide their title, license number, company name, license type, and work phone number at the end of the form.

After completing the form, it is important to review it for accuracy. The inspector's signature certifies the information provided, which will be used to evaluate the property's insurability. Ensure that all required documentation and photos accompany the form when submitted for underwriting consideration.

Key takeaways

When filling out and using the 4 Point Inspection form, it is essential to keep the following key takeaways in mind:

Complete Information: Ensure that all sections of the form are filled out completely, including the insured/applicant name, application or policy number, and address inspected.
Photo Documentation: Include required photos for each section, such as the dwelling, roof, plumbing, and electrical systems. This visual documentation is crucial for underwriting purposes.
Licensed Inspector: The form must be completed, signed, and dated by a Florida-licensed inspector. This ensures the credibility of the inspection findings.
System Condition: Clearly indicate the condition of each system inspected—roof, electrical, HVAC, and plumbing. Use terms like "satisfactory" or "unsatisfactory" and provide explanations where necessary.
Hazards and Deficiencies: Document any visible hazards or deficiencies in detail. This includes issues like leaks, corrosion, or unsafe wiring. Full disclosure is critical.
Supplemental Information: Provide additional details about each system, such as age, type of materials used, and any updates made. This information helps assess the property's overall condition.
Review by Agents: Agents should review the completed form thoroughly before submission. It is their responsibility to ensure compliance with all underwriting requirements.
Not a Warranty: Remember that the information provided in the inspection form is used to determine insurability only. It does not guarantee the suitability or longevity of the systems inspected.

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Documents used along the form

When conducting a 4-Point Inspection, several other documents may be necessary to provide a comprehensive overview of the property's condition. Each of these documents plays a crucial role in assessing insurability and ensuring compliance with underwriting requirements.

Home Inspection Report: A detailed report from a licensed home inspector, covering all major systems and components of the home, including structural integrity, roofing, plumbing, and electrical systems.
Roof Inspection Form: A specific form that evaluates the condition of the roof, detailing materials, age, and any visible damage or leaks.
HVAC Inspection Report: This report focuses on the heating, ventilation, and air conditioning systems, confirming their operational status and any maintenance performed.
Plumbing Inspection Report: A document that assesses the plumbing system, noting any leaks, water pressure issues, and the condition of fixtures and pipes.
Electrical Inspection Report: A thorough examination of the electrical systems, including wiring, panels, and any safety hazards present.
Insurance Application: The formal application submitted for insurance coverage, which includes property details and the owner's information.
Disclosure Statement: A document where the seller discloses known issues with the property, ensuring transparency in the transaction.
Repair Estimates: Cost estimates for any repairs identified during the inspection, which may be required for underwriting purposes.
Photos of Property: Visual documentation of the property's condition, typically required alongside the 4-Point Inspection to verify findings.
State Licensing Documentation: Proof that the inspector is licensed in Florida, ensuring that the inspection meets state regulations and standards.

Each of these documents contributes to a thorough understanding of the property's condition. Collecting and reviewing them is essential to facilitate a smooth underwriting process and ensure that all parties are adequately informed.

Sample - 4 Point Inspection Form

4-Point Inspection Form

Insured/Applicant Name:_________________________________________________ Application / Policy #:__________________________

Address Inspected:___________________________________________________________________________________________________

Actual Year Built:________________________		Date Inspected: ______________________________________________

Minimum Photo Requirements:
Dwelling: Each side	Roof: Each slope	Plumbing: Water heater, under cabinet plumbing/drains, exposed valves

Main electrical service panel with interior door label

Electrical box with panel off

All hazards or deficiencies noted in this report

A Florida-licensed inspector must complete, sign and date this form.

Be advised that Underwriting will rely on the information in this sample form, or a similar form, that is obtained from the Florida licensed professional of your choice. This information only is used to determine insurability and is not a warranty or assurance of the suitability, fitness or longevity of any of the systems inspected.

Electrical System

Separate documentation of any aluminum wiring remediation must be provided and certified by a licensed electrician.

Main Panel				Second Panel
Type:	Circuit breaker	Fuse		Type:	Circuit breaker Fuse
Total Amps: __________				Total Amps: __________
Is amperage sufficient for current usage?			Yes No (explain)	Is amperage sufficient for current usage?		Yes No (explain)

Indicate presence of any of the following:

Cloth wiring

Active knob and tube

Branch circuit aluminum wiring (If present, describe the usage of all aluminum wiring):

* If single strand (aluminum branch) wiring, provide details of all remediation. Separate documentation of all work must be provided.

Connections repaired via COPALUM crimp Connections repaired via AlumiConn

Hazards Present			Double taps
Blowing fuses			Exposed wiring
Tripping breakers			Unsafe wiring
Empty sockets			Improper breaker size
Loose wiring			Scorching
Improper grounding			Other (explain)
Corrosion
Over fusing

General condition of the electrical system:	Satisfactory	Unsatisfactory (explain)

Supplemental information

Main Panel	Second Panel	Wiring Type
Panel age: __________	Panel age: __________	Copper
Year last updated: __________	Year last updated:__________	NM, BX or Conduit
Brand/Model: __________	Brand/Model: __________

Sample Form Insp4pt 01 18

4-Point Inspection Form

HVAC System

Central AC:	Yes	No
Central heat:	Yes	No

If not central heat, indicate primary heat source and fuel type: _________________________________

Are the heating, ventilation and air conditioning systems in good working order?						Yes	No (explain)
Date of last HVAC servicing/inspection: ______________

Hazards Present
Wood-burning stove or central gas fireplace not professionally installed?					Yes	No
Space heater used as primary heat source?			Yes	No
Is the source portable?	Yes	No

Does the air handler/condensate line or drain pan show any signs of blockage or leakage, including water damage to the surrounding area?

Yes No

Supplemental Information

Age of system: _____________

Year last updated: _____________

(Please attach photo(s) of HVAC equipment, including dated manufacturer’s plate)

Plumbing System

Is there a temperature pressure relief valve on the water heater?			Yes	No
Is there any indication of an active leak?	Yes	No
Is there any indication of a prior leak?	Yes	No
Water heater location: _______________________________________________

General condition of the following plumbing fixtures and connections to appliances:
Satisfactory Unsatisfactory		N/A		Satisfactory Unsatisfactory	N/A
Satisfactory Unsatisfactory		N/A		Satisfactory Unsatisfactory	N/A
Dishwasher				Toilets
Refrigerator				Sinks
Washing machine				Sump pump
Water heater				Main shut off valve
Showers/Tubs				All other visible

If unsatisfactory, please provide comments/details (leaks, wet/soft spots, mold, corrosion, grout/caulk, etc.).

Supplemental Information

Age of Piping System:		Type of pipes (check all that apply)
_____	Original to home	Copper
		Copper
_____	Completely re-piped	PVC/CPVC
		PVC/CPVC
_____	Partially re-piped	Galvanized
		Galvanized
(Provide year and extent of renovation in the comments below)		PEX
		PEX
		Polybutylene
		Other (specify)

Sample Form Insp4pt 01 18

4-Point Inspection Form

Roof (With photos of each roof slope, this section can take the place of the Roof Inspection Form.)

Predominant Roof

Covering material: __________

Roof age (years): __________

Remaining useful life (years): __________

Date of last roofing permit: __________

Date of last update: __________

If updated (check one):

Full replacement Partial replacement

%of replacement: __________

Overall condition:

Satisfactory

Unsatisfactory (explain below)

Any visible signs of damage / deterioration?

(check all that apply and explain below)

Cracking

Cupping/curling

Excessive granule loss

Exposed asphalt

Exposed felt

Missing/loose/cracked tabs or tiles

Soft spots in decking Visible hail damage

Any visible signs of leaks? Yes No

Attic/underside of decking Yes No

Interior ceilings Yes No

Secondary Roof

Covering material: __________

Roof age (years): __________

Remaining useful life (years): __________

Date of last roofing permit: __________

Date of last update: __________

If updated (check one):

Full replacement Partial replacement

%of replacement: __________

Overall condition:

Satisfactory

Unsatisfactory (explain below)

Any visible signs of damage / deterioration?

(check all that apply and explain below)

Cracking

Cupping/curling

Excessive granule loss

Exposed asphalt

Exposed felt

Missing/loose/cracked tabs or tiles

Soft spots in decking Visible hail damage

Any visible signs of leaks? Yes No

Attic/underside of decking Yes No

Interior ceilings Yes No

Additional Comments/Observations (use additional pages if needed):

All 4-Point Inspection Forms must be completed and signed by a verifiable Florida-licensed inspector. I certify that the above statements are true and correct.

Inspector Signature	Title	License Number	Date

Company Name	License Type	Work Phone

Sample Form Insp4pt 01 18

4-Point Inspection Form

Special Instructions: This sample 4-Point Inspection Form includes the minimum data needed for Underwriting to properly evaluate a property application. While this specific form is not required, any other inspection report submitted for consideration must include at least this level of detail to be acceptable.

Photo Requirements

Photos must accompany each 4-Point Inspection Form. The minimum photo requirements include:

•Dwelling: Each side

•Roof: Each slope

•Plumbing: Water heater, under cabinet plumbing/drains, exposed valves

•Open main electrical panel and interior door

•Electrical box with the panel off

•All hazards or deficiencies

Inspector Requirements

To be accepted, all inspection forms must be completed, signed and dated by a verifiable Florida-licensed professional. Examples include:

•A general, residential, or building contractor

•A building code inspector

•A home inspector

Note: A trade-specific, licensed professional may sign off only on the inspection form section for their trade. (e.g., an electrician may sign off only on the electrical section of the form.)

Documenting the Condition of Each System

The Florida-licensed inspector is required to certify the condition of the roof, electrical, HVAC and plumbing systems. Acceptable Condition means that each system is working as intended and there are no visible hazards or deficiencies.

Additional Comments or Observations

This section of the 4-Point Inspection Form must be completed with full details/descriptions if any of the following are noted on the inspection:

•Updates: Identify the types of updates, dates completed and by whom

•Any visible hazards or deficiencies

•Any system determined not to be in good working order

Note to All Agents

The writing agent must review each 4-Point Inspection Form before it is submitted with an application for coverage. It is the agent’s responsibility to ensure that all rules and requirements are met before the application is bound. Agents may not submit applications for properties with electrical, heating or plumbing systems not in good working order or with existing hazards/deficiencies.

Sample Form Insp4pt 01 18

Dos and Don'ts

Things to Do:

Ensure all sections of the form are completed thoroughly.
Include clear and recent photos for each required area.
Have a Florida-licensed inspector sign and date the form.
Document any updates or repairs made to the systems.

Things Not to Do:

Do not submit the form without verifying all information.
Avoid using outdated photos that do not represent the current condition.
Do not leave any required sections blank or incomplete.
Do not submit the form if any systems are found to be in poor condition or have hazards.