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Underwriting
justquotesrmation: |
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Describe
IN DETAIL, Your Business Operations: |
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Ownership & Payroll
Data: |
List Employee's Annual
Payroll Here (if none, enter $0): |
$ |
Insert #
of Employees here: |
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Location & Sales
justquotesrmation: |
Insert Annual Gross
Revenues from this operation here: |
$ |
Square Footage of
office or business location: |
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Type of Building (wood
frame, concrete, etc.): |
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Number of Stories:
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Are there other
business/residences in this building (describe)?: |
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Describe safety
features (alarm, sprinklers, fire protection, etc): |
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Coverage Desired: (Check
One Please) |
The Coverage I Am
Looking For:
Liability Only
Liability & Business Contents Liability, Building &
Contents Coverage
A Package Policy Including the
Above, Plus
Miscellaneous Coverages
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NOTE: Don't worry if you are
not exactly sure about coverage type... we will suggest the best
coverage for you - just try to tell us what you are looking for! (If
we need more justquotes. we will let you know.) |
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Liability
Coverage: ($1 Million, $2 Million, $3 Million,
etc.) |
$ |
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Business
Contents Coverage: (The amount of your personal
business property) |
$ |
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Building
Coverage: (The amount of building coverage if
you own your bldg.) |
$ |
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Miscellaneous Coverage: (List any
special coverage peculiar to your business, such as Garagekeepers
Legal, Loss of Earnings, ValuAble Papers, etc.) |
$ |
Select Any Optional coverages You'd Like Quoted:Directors and Officers Coverage Professional or Errors and Omission
Coverage Group Health Insurance Coverage Workers Compensation Coverage Business Auto/Vehicle Coverage Business Property Coverage Disability
Coverage Life Insurance
Coverage
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