Commercial Property

Company Name*

Legal Entity Type*

Business Start Year*

EIN*

Property Address (the address needing coverage)*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Is there a different Mailing Address?*

YesNo

Mailing Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Phone Number*

Please enter a valid phone number.Format: (000) 000-0000.

Email*

example@example.com

Owner/Primary Contact Name*

First NameLast Name

Date of Birth*

Date

Gender*

MaleFemale

Describe the business operations. (ex. doctors office, flooring contractor, clothing store, restaurant, church...)*

Estimated Annual Revenue (total amount received for your services before taxes and expenses)*

Does the business have employees?

YesNo

How many?*

How much do you pay them per year? (total payroll)*

How much building personal property coverage do you need? In other words, what is the total value of all property inside the building? *

Have any updates or renovations been made to the original building such as HVAC, plumbing, electrical, roofing, etc? Please specify type of update and year updated.*

Does the building have any safety/security features to prevent damage such as burglar alarm, security system, monitored fire alarm, indoor sprinkler system, etc? *

Describe your current coverage status*

I currently have property insuranceI had coverage but it was cancelled/expiredI have never had property insurance

What is the expiration date of your current policy?*

How long has it been since you've had coverage?*

Do you want to add General Liability coverage to the quote too?*

YesNo

Please upload any documents that may help us quote (identification, prior coverage, etc.)