First Eagle Insurance: Commercial Insurance. ACQ

FREE COMMERCIAL INSURANCE QUOTE
FREE, NO OBLIGATION ARTISAN CONTRACTOR'S INSURANCE QUOTE

COMMERCIAL INSURANCE TERMS | COMMERCIAL INSURANCE COVERAGE | FREE APARTMENT BUILDING INSURANCE QUOTE | FREE BUSINESS OWNER'S PACKAGE INSURANCE QUOTE | FREE BUSINESS LIABILITY INSURANCE QUOTE

GENERAL INFORMATION

1. First Name:

Last Name:

Name of Legal Entity, if other

2. Phone:

3. Email:

4. Business Name:

5. Mailing Address:

City:

State:

Zip Code:

6. Do you operate your business from your residence?

Location Address:

City:

State:

Zip Code:

7. Ownership type:

8. Years in Business:

years

9. If new, what type of business experience do you have?

10. Are you currently insured?

11. If yes, Number of years continuously insured:

years

12. Name of Current Insurance Company:

12a. Policy No:

13. Losses-claims in the last 5 years:

14. If any Losses, provide date, amount paid and reserves, description, and steps taken to avoid future losses:

15. Has your insurance ever been canceled or non-renewed?
16. If yes for what reason?

17. Nature of your business operations: (General Contractor, Electrical Contractor, Plumbing Contractor, Roofer, Painting Contractor, etc.)

18. Gross annual sales or receipts:

19. Number of owners or officers:

20. Annual payroll for all owners or officers:

21. Number of full time employees:

22. Annual payroll for all full time employees:

23. Number of part time employees:

24. Annual payroll for all part time employees:

25. Total yearly sub costs:

26. Type of work sub-contracted:

27. Contractor's license number:

28. License type:

29. Expiration Date:

30. Percentage of work done as General Contractor:	%
31. Percentage of work done as Sub-Contractor:	%
32. Percentage of work done on Residential:	%
33. Percentage of work done on Commercial:	%
34. Percentage of work done on Remodeling:	%
35. Percentage of work done on Renovation:	%
36. Percentage of work done for Repair-Maintenance:	%
37. Do you do any exterior work on buildings over 3 stories high?
38. Do you do any asbestos removal:
39. Do you work on new residential properties, town homes, condominiums, row homes, apartments, housing projects or dwellings prior to certificate of occupancy?
40. Have you had any construction defects, products liability or other negligence claim made against you?
41. Have you been named in a lawsuit alleging construction defects?
42. Do you draw plans, designs, specifications?

COVERAGE

43. General Liability Coverage:
44. Products/Completed Operations Coverage:
45. Personal/Advertising Injury Coverage:
46. Liability General Aggregate Limit:
47. Fire Legal Liability Coverage:
48. Professional Liability Coverage:
49. Deductible:
50. Number of additional Insured:
51. Your business relationship with each additional insured: (Landlord, Job Owner, Contractor, etc.)
52. Other required coverage: (please provide coverage type and amount required)

Licensed in State of California.

LICENSE #: 0787078

Phone: (800) 316-3002
Fax: (818) 500-1855

Email: info@firsteagle.com