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Info needed for business insurance
Mike Hackl
Hackl & Associates Insurance
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Your Name
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Business Name & Address
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Phone number
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Email address
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confidential & not shared
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How did you hear of our agency?
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Do you have your personal auto and home with Hackl Insurance?
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If we can bundle all your insurance and get better rates are you open to switching your auto and home?
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Brief description of business
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Business type
Individual (sole proprietor)
LLC
Corporation
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Insurance to quote
(check all that apply if known)
General liability
Property - building
Property - contents
Workers compensation
Business auto
Business umbrella
Website
If applicable
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Years in operation
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Current insurance company
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Other comments
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Today's Date
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