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Commercial Building Insurance
* = Required Information
This is not an instant quote website; our prices are too low to list online. Please fill out the quote form to obtain a Commercial Building insurance quote, and an insurance specialist will contact you shortly. Please understand this is not an application for insurance. An application will be sent to you if coverage is desired.
 
Proper Protection Fact Finding Questions
Of the following, what is the primary reason for a quote request? Requesting More Information 
Loan Required 
Replace Investment 
Liability Protection 
In the order of importance, what is most important to you? Price 
Service 
Proper Coverage 
Approximately when was the last time you did a review with your agent? Within the year 
Over 2 years ago 
Over 5 years ago 
Never 
Would you be interested in going to higher deductibles to reduce your premium? Yes 
No 
In the event of a lawsuit, accident, or judgment would you want to: Maximize Protection 
Assume Some Risk 
In the event of an untimely death, is it important to you that you're surviving spouse and/or children maintain the quality of life you currently have together without debt? Yes 
No 
Would you be interested in combining your commercial insurance for additional savings? Yes 
No 
If health insurance is provided for employees, would you like to save money? Yes 
No 
Requesting More Information 
Has your current company/agent failed to meet your expectations in any way? Yes 
No 
What else must I do to earn your business?
Contact Information
First Name
Business Name
Gender Male     Female 
Date of Birth
Occupation
Business Address
Zip Code
The Best Time to Call?
Best Phone Number to Reach You
Fax
Email Address *
Building Information
Building Replacement Cost
Building Square Footage
Year Built:
Construction Type
Roof Type
Liability Amount
Contents Amount
Location Deductible
What is the primary occupancy type?
Number of Stories
Is there a brush hazard within one mile of the building? Yes 
No 
If yes, has the brush been cleared by 250 feet from all sides of the building? Yes 
No 
Automatic Fire Sprinklers Yes 
No 
Automatic Fire Sprinklers System Type Fully Sprinklered 
Partially Sprinklered 
N/A 
Do You Need an Umbrella Policy?
Do you want Blanket Coverage to apply to all locations of building and/or contents? Yes 
No 
What is the Website address of insured?
How many years of management experience in this industry does the applicant have?
Are there any locations or business interests which are owned by the applicant but not shown on the application? Yes 
No 
How many Property Additional Interests (Mortgagees/Loss Payees/Additional Insured) are required?
Total Annual Receipts/Sales or loss of rents from the location?
Number of Full-time Employees
What percentage of the building is occupied by the applicant?
What percentage of the building is vacant or unoccupied?
Does the applicant require all tenants to carry property and liability insurance? Yes 
No 
Is a professional property management company used at this location? Yes 
No 
Is the original design intended for the type of operations being conducted at this location? Yes 
No 
Does any tenant conduct manufacturing operations at this location? Yes 
No 
Is the applicant responsible for the parking lot? Yes 
No 
Additional Information: