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Business Insurance Checklist
Business Insurance Checklist
General Information
Name:
*
Legal Name of Business:
Address
Street Address
City
State
Zip Code
Business Phone:
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Email:
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Insurance Needs
Choose Lines of Insurance You Are Interested In
Commercial Auto
Aviation
Business Interruption
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Commercial Liability
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Hotel/Motel
Liquor
Medical Malpractice
Office Pkg/Prof. Liability
Product Liability (E&O)
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Workers' Compensation
Other
Please Explain Other:
Current Insurance Information
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Years Insured:
Policy Expiration Date
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About Your Business
Number of Employees:
Number of Locations:
Years in Business:
Annual Sales:
Detailed Description of Your Business:
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