Commercial Insurance General Liability / BOP / Package Insurance Quote Request

General Liability/ Package Quote Request

Name(Required)

First Last

Business Name(Required)

EIN or Social Security #(Required)

Email(Required)

Phone(Required)

Website

Address(Required)

Street Address Address Line 2 City State ZIP Code

Year building occupied was built(Required)

Year Roof was last replaced(Required)

Year HVAC was last updated(Required)

Year Electrical was last updated(Required)

Year Plumbing was last updated(Required)

How many sq ft does your business occupy(Required)

How many sq feet is the entire building(Required)

What floor is your office located on?(Required)

How many floors are in the building?(Required)

What type of business are you in?(Required)

Number of years in operation(Required)

Any losses in the last 5 years?(Required)

If you had losses or claims please provide as much detail and date info as possible(Required)

How many employees does your business have?(Required)

Have you had any insurance claims in the past 5 years? If so, when and please provide detail and amount of loss.(Required)

Annually, my business earns (before taxes)(Required)

Annually, I pay myself(Required)

Annually, I pay my employees(Required)

Annually, I pay my Full Time employees(Required)

Annually, I pay my Part Time employees(Required)

How many Full Time Employees(Required)

How many Part Time Employees(Required)

In what type of building do you operate your business?(Required)

Does it have an automatic fire suppression system?(Required)

What % of your space is sprinklered?(Required)

For property claims, I want to pay a deductible of(Required)

For my business property and equipment, I'd like to be covered up to(Required)

We'd like to be able to send you text messages from time to time. Please confirm it is ok to send text messages and automatic email messages.(Required)

Limit of Liability Requested(Required)

For claims against my business of property damage, I want to pay a deductible of(Required)

If available would you like Equipment Breakdown Coverage Add this coverage to protect your business equipment from unexpected events like power surges or outages.(Required)

If available would you like Hired and Non-Owned Auto Coverage Add this coverage if your business uses personal autos for work-related reasons.(Required)

Untitled

320 High Tide Dr
St Augustine FL 32080
Get directions
904-347-6727
matt@seamansinsurance.com

Call or Text: 904-347-6727

Commercial Insurance General Liability / BOP / Package Insurance Quote Request

General Liability/ Package Quote Request

CONTACT US

CONNECT WITH US ONLINE!

Get Directions

904-347-6727