Commercial Property Insurance
Please complete this form below to the best of your ability. We'll shop our markets and present the best option based on the data you provide us.
When do you need coverage to start?
-
Month
-
Day
Year
Date
Business Contact Information
Legal Name
First Name
Last Name
Date of Birth
Phone Number
*
E-Mail
*
Email
Describe your relation to the property:
I am the owner
I am the manager
Other
Entity Name To Be Insured (HOA, LLC, INC, etc)
Example, LLC or Movement, Inc.
Business Mailing Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Property Address To Be Insured
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
What Year Was The Building Built?
Number of Units
Square Feet of Building
Does the Building Have Sprinklers Inside the Units?
Yes, building(s) do have sprinklers
No, no sprinklers in the building
Updates / Maintenance
How Old Is The Roof?
Less than 1 year old
Less than 5 years old
About 10 years old
Not sure-but older than 10 years old
How Old Is The Plumbing?
Less than 1 year old
Less than 5 years old
About 10 years old
Not sure-but older than 10 years old
Is your business currently insured with an active policy?
Yes
No
No-New Business Venture
Have you filed ANY business insurance claims in the last 5 years?
Yes (If yes, please upload Loss Runs below)
No
Do you have any W2 employees?
Yes
No
Annual Rent Roll or Income
*
Do you have any cars that are registered to the business?
Yes
No
Upload Loss Runs, Prior Declaration Page, etc.
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