Commercial Property Intake Form

Commercial Property Insurance Intake Form
Which BIG Agent are you working with?
An Agent will be assigned if unlisted
Client Information
Owner Name

First NameLast Name
Date of Birth

MonthDayYear
Date
Owner's Contact Info

Phone NumberEmail
Business Name
Entity Type
LLC, S-Corp, LP, C-Corp, Joint Venture
EIN
Year of Construction
Date Property Acquired

MonthDayYear
Date
Years of Management Experience in the Industry
Business Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Mailing Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Are there any locations or business interests which are owned by the applicant but not shown on this application?
Preferred Contact Method
Number of Tenants
Total sqft:
Sqft of Owner Occupied Space
Occupancy Rate (%)
List of Tenants and Description of Business Operations and Products
Please upload pictures of the building.

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Type of Construction
Type of Building
Are the following updated?
Updated Year
Sprinkler Installed (100%) / All Units?
Central Fire/Burglar Alarm?
Annual Rental Income ($)
Please Upload Copy of Current Policy.

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Current Insurance Carrier
Current Building Coverage ($)
Current Annual Premium ($)
Current Liability Coverage ($)
Current expiration date

MonthDayYear
Date
Please let us know about any optional coverages that must be included.
Who referred you to BIG?
Referral info

First NameLast Name
Contact Info

Phone NumberEmail
Additional Interests / Lender Information
NAME / COMPANY
Certificate Holders (Owners, Landlords, Property Managers, etc)
What Happens Next?

Immediate Action: We begin working on the insurance quotes as soon as we receive this form completed.
Contact: Our office can be reached at +1(512)255-5555

Thank you for trusting us - we appreciate growing with everyone we interact with!
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Commercial Property Insurance Intake Form

Client Information

Who referred you to BIG?

Additional Interests / Lender Information