All-risks Insurance Brokers - Commercial Property/Liability Insurance

Welcome to our online commercial property/liability quote page. Please take a few minutes to fill out the questionnaire below, submit and we will e-mail back your free quotation within 48 hrs. If you wish us to contact you by telephone simply complete the "Daytime Phone" box and one of our representatives will contact you with your quotation.

Note: For an accurate quotation all fields should be completed.

Business Name
Contact Name
Street
City
Postal Code
E-mail address
Daytime phone

Multiple Location

Please submit a new form for each property or business owned.

This is location of .

Street
City
Postal code

General Information

Type of Business
Type of Products and/or Services Sold
Manufacture Own Products ?
Target Premium
Policy Deductible

Building - (complete even if leasing)

Value (if owned)
Is all or a portion of this building rented to others ?
If yes, amount of annual rent collected.
Year Built
Construction -	Walls
	Floor
	Roof
# of floors
Basement
Square Footage of Building
Square Footage you Occupy
Occupied by Others as
Adjacent Occupancies
Distance to closest Fire Station
Distance to closest Fire Hydrant
Alarm System
Alarm Alerts for		Intrusion Fire	Smoke CO
# of Fire Extinguishers
Serviced Annually
If deep fat frying is done on the premises, is an overhead fire suppression system in place
If yes, type

If the building is older than 20 years please provide dates (or approximate dates) when the following were last updated.
Plumbing
Primary Heating
Roof
Wiring
Indicate type of service
Plumbing
Primary Heating
Supplementary Heating	Type
Roof
Wiring
Transformer on Premises
Air Compressor on Premises
If any of the following are attached to the building please state value.
Sign (value)
Clock (value)
Antennas/Towers (value)
Glass Coverage Required
Linear Footage of Glass

Production Equipment (value)
Total Stock (value)
Perishable Stock (value)
Work in Progress (value)
Tools on Premises (value)
Leasehold Improvements (value)
Office Equipment (value)
Computer & EDP Equipment (value)
Computer Software (value)
Property of Others (value)

Crime

Is cash kept on premises?
Amount (value)
Overnight (value)
Daily Deposit Amount
Safe on Premises
Class & Fire Rating
Employee Dishonesty Coverage
Employee Bonding Required

Additional Coverages

Water Escape/Sewer Backup
Flood
Earthquake
Exterior Sign(s) (value)
Transit (value)
Temp Locations (value)
Tool Floater (value)
Equipment Floater (value)
Misc. Equipment
Other (describe)

Operations / Liability

Amount of Liability
Total Annual Sales (value)
Liquor Sales (value)
Sales to U.S. (value)
Cost of Sales (value)
Ordinary Payroll (value)
Key Person Payroll
# of Employees
Years in Business
Years in this Industry
Do your employees use their own vehicles on behalf of your business?
Cranes or Hoists on premises
If yes, value of highest amount hoisted (value)
Are you interested in a quote for a Liability Umbrella?
If yes, amount
How many vehicles do you own?

Insurance History

Current or Most Recent Insurer:

Policy Renewal Date or Last Date Insured:

# of years consecutively insured

Policy Cancelled in the last 3 years. (Date & reason)

List all Claims in the past 5 years. (Date, Type, Amount Paid)
Claim 1
Claim 2
Claim 3
More than 3 claims

This quotation is based on the information you provide. If the quote is satisfactory and a policy is desired, an insurance claims and experience history will be obtained. If information differs from the information stated, policy premium may be affected. Please be accurate.