Commercial Property Quote
Please complete the following short form and we'll get back to you with a premium quote for
your building coverage.
Name of Contact:
City:
 Zip:
Email:
Year built:
 Fire resistive:
 Sprinkler:
 Central station
alarm system:
No. of stories:
 Brick:
 Attached:
Total area sq. footage:
 Frame:
 Detached:
No. of retail stores:
 Type of business:
 Total retail sq. footage:
No. of offices:
 Type of business:
 Total office sq. footage:
No. of residential apts:
 Total residential sq. footage:
Type of business adjacent to left of you:
 Right of you:
Building:
 Water damage:
 General liability:
Content:
 Burglary:
Loss of income:
 Glass - specify
sq. footage:
Specify glass sq. footage:
Currently insurance
company:
Insurance loss/claim
in the past 3 years:
Owner name:
Building address:
Phone
Building
information -
check all that
apply:
Mortgagee's
name & address:
Proposed
effective date: