Business Insurance App









Location or Contact Info.


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Liability coverage

Retail / Service


















Second Retail Location
















Third Retail Location
















Real Estate
Location


















Coverages:
If you own the building you can insure the value
Coverage for non-building items on premise
Coverage for non-building items OFF premise


Business Income, E&O, Workers Comp, etc.
Habitational


Location 1















Location 2















Location 3















Location 4















Location 5















Location 6















Location 7















Location 8















Misc HOA questions:


Company Info:










Restaurant





























Restaurant Location 2




























Restaurant Location 3




























Auto Service Repair

























Specialized questions:











Garage Keepers Liability

Usually 20K X number of cars

Auto Service Repair Location 2
























Specialized questions:











Garage Keepers Liability

Usually 20K X number of cars

Artisan Contractor














Full time Part-time Actual duties performed Annual payroll
Owners/Execs
Artisan Workers
Foreman
Clerical / Office
Sub-Contractors
Additional Notes

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