Buffalo Agency Inc_24-0035-00_Business Owners Policy (BOP) Quote

Please complete the following BOP quote form and submit for a comprehensive analysis of plans and rates that are available to you at this time. A Buffalo Insurance Business specialist will contact you after the submission has been made.

Per Our Privacy Policy, we will never sell your personal information to a third party. All information is confidential and for the sole use of Buffalo Insurance to provide your quote.

Select an Agent Preference or Agent you are currently working with:*

BUSINESS INFORMATION

Insured Name:*

First NameLast Name

Contact Number:

Please enter a valid phone number.

Do you agree to receive text messages from the Buffalo Agency using the contact information provided? Message frequency varies and may include coverage information, appointment reminders, service, or order information. Message and data rates may apply. Reply STOP at any time to end or unsubscribe. For assistance, reply HELP or contact support at: 501.843.6999.

Yes, I agree to receive text messages from Buffalo Agency.No, I do not want to receive text messages from Buffalo Agency.

See our Terms & Conditions for details on how we handle your information.

Email Address:*

example@example.com

Business Legal Name:*

Business Tax ID:

Business Website:

Address:*

Street Address

Street Address Line 2

CityState

Zip Code

BUSINESS MODEL

Type of Business:*

Legal Entity (LLC? Corp? Partnership?):*

Years In Business:*

Years of Management Experience:

Describe all the services provided by your business:*

Hours of Operation:

Annual Sales $:*

Is your loss ratio or shrinkage (average annual losses/quoted premium) less than 40%?*

YesNo

BUSINESS ASSETS

Does the business own any company or commercial vehicles?

YesNo

If YES, how many?

Vehicle Descriptions:

Does Business have multiple locations?*

YesNo

Notice: For Businesses with multiple locations, we will have to eventually gather the specs below for each location.

Building / Property Owned or Leased?*

OwnedLeased

Value $:*

Year Building Built:*

Type of Construction:

Number of Stories:*

Square Footage:*

Burglar Alarms Active?*

YesNo

Fire Alarms Active?*

YesNo

BUSINESS EMPLOYEES

Number of Full Time Employees:*

Number of Part Time Employees:*

Do You Use Temp Employees?*

YesNo

Do You Use Sub-Contractors?*

YesNo

Annual Payroll $:*

CURRENT COVERAGE / COVERAGE NEEDS

Current Insurer Carrier:*

Desired/Renewal Premium:

Liability Limits Desired:*

300K500K1Million

Any outstanding suits or liens against the business and/or any bankruptcies last 3 years?*

YesNo

If YES, Please Explain:

HOW ELSE CAN WE HELP YOU TODAY?

Some of our clients have saved over 20% on their auto and home insurance by letting us shop for a better rate.

Would you like to see if we can save you money on your AUTO INSURANCE?*

YesNo

Would you like to see if we can save you money on your HOME INSURANCE?*

YesNo

Are you interested in GROUP HEALTH INSURANCE?*

YesNo

Are you interested in INDIVIDUAL HEALTH OR LIFE Insurance?*

YesNo

Are you interested in Supplemental Policies for added coverage for CANCER or DISABILITY Insurance?*

YesNo

REQUIRED. By checking this box, I understand that the Information provided above (and, possibly, additional information) to be used to get non-binding pricing indication.*

I AGREEI DO NOT AGREE

Please verify that you are human*

BUSINESS OWNERS POLICY (BOP)