Commercial General Liability Quote Sheet

Amator Horn Insurance Agency Commercial General Liability Quote Sheet

1. Do you have current insurance? With whom? Fax or come by to look at? Any claims?

2. Year business began? Prior Insurance Policy #'s with whom and what year for past 4 years if available.

3. Name of business: 4. FEIN # 5. Address: 6. DBA 7. Phone # 8. Brief description of the nature of the business

9. Employees/MVR's

10. Annual Gross Receipts/Annual payroll

11. Liability normally at 1,000,000/2,000,000. That will be quoted unless otherwise specified.

12. Location Information: Year built: Square Footage: Metal or Wood Construction: Type of Roof and when it was last replaced: Office on Premesis:

13. Value of Building Business Personal Property: Value on Tools: Value on Computer Equipment: Value on Office Equipment: Value on Inventory: 9 Hours of Operation:

Sprinklers in building:

 ................
................

In order to avoid copyright disputes, this page is only a partial summary.

Google Online Preview   Download