Commercial Insurance

Business Name

Entity
--Select--INDVCORPLLCPRTNOTHER

Building Construction
--Select--Wood FrameBrick or ConcreteFire ResistiveOther

Is your property?
--Select--Owner OccupiedTenant OccupiedVacantUnder course of construction

Type of Business :

Years In Business :

Years Experience :

Property Address

Email Address

Website :

Type of Business :
--Select--OfficeLessor’s RiskWholesalerManufacturerRetailerServiceRestaurantApartment Building

Description Of Operations:

Current Carrier:

Exp Date

Policy #

Current Premium

Any losses?
--Select--YesNo

Loss Description

Status
--Select--OpenClosed

Do You Have Employees?
--Select--YESNO

If yes, How Many?

Estimate

Estimated Gross Sales: $

Liquor Sales (Beer, Wine, or hard liquor)
--Select--YesNo

Has the building been renovated?
YesNo

Plumbing Year Renovated

Electrical Year Renovated

Roof Year Renovated

Heating Year Renovated

Building Structure:
--Select--FrameJoisted MasMason-Non-CombFire ResistiveUnknown

Fire Sprinkler
--Select--YESNO

Central Alarm
--Select--YESNO

Total Sq. Feet

Public SQ. Feet:

Building Updated
--Select--YesNo

Number of Stories

Number of Buildings

Year Built

Hours of Operation

General Liability Limits:
--Select--$500k/$1mm$1mm/$2mm$2mm/$4mm

Building Limits

Contents

Restaurant Equipment/Tenant Improvement value

Delivery or Catering?
--Select--YesNo

Any Entertainment, dance floor, and happy hours?
--Select--YesNo

Other Quote Options
Professional LiabilityUmbrellaGarageAutoErrors & Omission