88 Insurance Online Quote
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Email address
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Your email
Owners Name
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Business Name
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Phone Number
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Fax Number
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Business Address
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Type of Ownership
Individual
Partnership
Corporation
Other
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Description of Your Business
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New Venture?
Yes
No
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If Yes, Number of Past Experiences (years)
Your answer
If No, How Many Years at Present Location (years)
Your answer
Current Insurance Company
Your answer
Current Insurance Policy Number
Your answer
Expiration Date
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Loss History
Yes
No
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If Yes, Explain
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How much do you want to have General Liability Coverage?
$500,000
$1,000,000
$2,000,000
Other:
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Annual Gross Sales
Your answer
Annual Payroll
Your answer
Do you need Liquor Liability?
Yes
No
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Percentage Sale of Alcohol
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Want to have Building coverage?
Yes
No
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If Yes, How much
Your answer
Want to have Contents coverage?
Yes
No
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If Yes, How much
Your answer
Do you need Theft coverage?
Yes
No
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Year built of the building?
Your answer
Remodeling year?
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Number Of Stories
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Total Area
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Customer Area
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How many days open
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Business Hours
Your answer
Have a Sprinkler
Your answer
Have a Alarm
Your answer
Tell me who is right side
Your answer
Tell me who is left side
Your answer
Memo
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Send me a copy of my responses.
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