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General Liability (BOP) Quote

Please try to fill out the entire questionnaire. The more questions answered, the more accurate quote we can provide you with better coverage and pricing.

After you submit this questionnaire, email your current or renewal Declaration Pages of the policy to us. By providing it, you will be able to compare "apples to apples" our quote to your policy.

General

Name on Policy
Requested Effective Date
Mailing Address on Policy
Business Phone
Business FEIN #
Website
Contact Name
Contact Title
Contact Phone
Contact Email

Property

Property Address
Interest

Number of Full-Time Employees
Number of Part-Time Employees
Occupied Area (SQFT)
Total Building Area (SQFT)
Description of Operations (owner or Tenant(s) occupies building)
Any uncorrected fire and/or safety code violations?


If yes, please provide details
Building Construction Type
Number of Stories
Year Built
Wiring (electrical box)
Plumbing
Heating
Roof (age)
Material of Roof
Burglar Alarm Serviced By
Alarm Type

Sprinkler System?

Mortgage Loan?

Mortgage Loan Amount
Coverage Amount for Building

General Liability

Years in Business
Years of Experience
Any Losses in Past 3 Years?

Limits and Deductibles
General Aggregate
Products Completed Aggregate
Damage to Rented Premises
Personal & Advertising Injury
Each Occurrence
Medical Expense
Limit Assault and/or Battery (per occurrence)
Limit Assault and/or Battery (aggregate)
BI/PD Combined Per Claim (deductible)
List any additional coverages and limits desired (eg Business Interruption)

Please email us a copy of your current auto insurance policy declaration pages to us at [email protected] or [email protected] so we can verify the driver names, vehicle VIN number, coverages, deductibles, and expiration date.


When you fill out a web form, email us, or chat with us, you are voluntarily giving us information. This might include an email address, contact information, physical address, company information, phone number, and any other information pertinent for an insurance quote. We will not sell or rent this information to anyone. We will not share your information with any third party outside of our organization, other than as necessary to fulfill your request, e.g., for an insurance quote with a carrier. Unless you ask us not to, we may contact you via email in the future to tell you about insurance options, new products or services, or changes to this privacy policy.

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