Online Commercial Property Insurance Quote

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. Please complete all of the following information fields so that we are able to provide you with an accurate quotation. Note: All fields must be complete in order to process your quotation, except for those fields or sections marked as "optional".

GENERAL INFORMATION
Business Name*
Contact Name*
Prefix First Last
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Email*
Daytime Phone*
Effective Date*
Current Insurer*
MULTIPLE LOCATIONS

Please submit a new form for each property or business owned.
This is Location:*
of:*
Business Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Business Type*
Please Select One
If other, please specify:*
Form of Business
- Individually Owned
- Corporate
Type of Products and/or Services Sold:*
Manufactures Own Products:*
- Yes
- No
Target Premium
Policy Deductible*
Please Select One

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

CRIME
Is cash kept on premises:
- Yes
- No
Amount (value)*
Overnight (value)*
Daily Deposit Amount*
Safe on Premises:
- Yes
- No
Class and Fire Rating*
Employee Dishonesty Coverage*
Please Select One
Employee Bonding Required*
Please Select One

INSURANCE HISTORY
Current or Most Recent Insurer*
Policy Renewal Date or Last Date Insured*
MM
DD
YYYY
Number of Years Consecutively Insured:*
List all claims in the past 5 years:
Claim #1
MM
DD
YYYY
Claim #1 Type
Claim #1 Amount Paid
Claim #2
MM
DD
YYYY
Claim #2 Type
Claim #2 Amount Paid
Claim #3
MM
DD
YYYY
Claim #3 Type
Claim #3 Amount Paid
More than 3 claims?
- Yes
- No
Please list any additional information in the box below:

Online Commercial Property Insurance Quote

Step 1 of 7

GENERAL INFORMATION

MULTIPLE LOCATIONS

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

BUILDING

Please complete the following even if leasing.

Construction:

ADJACENT OCCUPANCIES

Please state business types/residencies surrounding your location. (i.e. Left Side - Law Firm, Right Side - Variety Store, Front - House, Behind - Alley)

Indicate type of service for the following:

If any of the following are attached to the building please state value:

CONTENTS

CRIME

ADDITIONAL COVERAGES

OPERATIONS/LIABILITY

INSURANCE HISTORY

List all claims in the past 5 years:

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