Garage Quote




Business Name

Business Entity

Contact Person

Property Address

City

State

ZIP Code

Mailing Address if different

City

State

ZIP Code

Phone
- -

( ### )        ###            ####

Fax
- -

( ### )        ###            ####

E-mail

Web Site





SECTION BREAK

Square Footage of Building Occupied

Year building built

Number of Stories

Building Construction Type

Building Has Automated Ceiling Sprinklers?

Please Describe in Detail the Type of your business

What are some of the types of products sold?

Payroll

Total Annual Gross Receipts

Years of Experience

Years you have owned this business

Central Station Alarm?

Building Coverage Amount if Owned

Contents coverage amount

Garage Keepers Coverage

Physical Damage (DD)

Deductibles (DD)

Employees tool coverage (DD)?

Amount

Do you currently have insurance?

Losses in Last three Years (Please Describe and Loss Amount)

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