Please provide information for your commercial property quote Remember that no coverage is considered bound unless you are notified by our agency
Please describe your business: *
What is the address of the property: *
Do you own the building you are in: *
Yes No
Please provide information about the building you own
Is there a mortgage on the building: *
Yes No
Name and address of mortgage company: *
Please provide information about the building you occupy
Please provide general information about the building
What is the year that the building was built: *
Please describe any updates to roof, heating, and electrical systems: *
What is the construction of the building: *
Frame (siding, wood) Brick (wood studs) Masonry Concrete Steel Other
Does the building have a sprinkler system: *
Yes No
Does the building have a fire alarm: *
Yes No
Is it connected to Central Station: *
Yes No
How far away is the building from the nearest fire hydrant: *
Does the building have glass plates: *
Yes No
Please provide the dimensions of the glass by plate: *
Do you have a sign: *
Yes No
Is it attached to the building: *
Yes No
Please provide information about the contents (inventory)
What is the value of your contents (inventory): *
Does your inventory value fluctuate more than 25% for a certain season: *
Yes No
Do you have possession of property of others as a general course of business: *
Yes No
Liability Information
What liability limit would you like to apply: *
$1,000,000 $500,000 $300,000 Other
Please provide contact information
Contact name: *
E-mail address: *
Phone number: *
Type of phone number: *
Business/work Home Mobile
What is the best time to contact you: *
How did you hear about us?: *
I am a current customer A Friend Internet Search Engine Newspaper Other Employee
Additional Information
Comments or additional information:
Did You Know Fences are not included in most property policies without being separately scheduled.
Would you like someone to contact you about this: *
Yes No
