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Commercial Property/Liability Insurance Quote
Company name
*
First name
*
Last name
*
Phone number
*
Email
*
Mailing Address
*
City
*
Province
*
Location of Operation
*
Do you own or rent the building you are operating out of?
*
Rent
Own
Age of Building
*
Description of Operations
*
Type of operations/Job Duties/Responsibilities
Years Experience in Industry
*
Year Experience as Principle Insured in Same Industry
*
Claim History
Please describe any losses or claims within the past 5 years (including dates)
Estimated Annual Gross Receipts
*
(Annual/Expected Revenue before expenses)
Requested Limit of Liability
*
$1,000,000
$2,000,000
$3,000,000
$4,000,000
$5,000,000
Other
Equipment Value
*
(Tools, Equipment, Machinery, Contents, etc)
Comments
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