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.

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)