Business Insurance - Get a Quote
Home
About Us
Overview
Auto Insurance
Bike Insurance
Boat Insurance
Home Insurance
Life Insurance
Health Insurance
Business Insurance
Tec Error Insurance
Financing
Order DMV Reports
Contact Us
Business Insurance
Overview
Online Quote
Full Name
*
Address
*
Town
*
State
*
Zip Code
*
Business Phone
*
Home Phone
*
Best Time to Call
E-mail Address
*
Occupation
*
Employer
*
Social Security #
*
Underwriting Information
Number of Owners
Payroll of Owners
Number of Employees
Payroll of Employees
Total Annual Gross Receipts
Total Annual Sub Costs
Business License Number
License Type
Years of Experience
How many years have you operated under your current Business Name?
Have you use any other Business Names during the past 5 years?
Yes
No
Is This Business Open 24 Hours A Day?
Yes
No
Any Deep Frying (Food)?
Yes
No
Is There Any Manufacturing, Mixing, Re-Labeling or Repackaging of Products?
Yes
No
Is there Filing Of Propane Tanks?
Yes
No
Please Describe the Nature of Your Business and ANY Unusual Exposures
Building and Property information
Total Square Footage of the Building Your Business is in
Total Square Footage of Your Business Only
Square Footage of the Customer Area Only
How Many Stories
Ground Floor Square Footage
Construction Type
Frame
Masonry
Masonry Veneer
Superior
Non Combustable
Roof Type
Tile
Slate
WoodShake
Composite Material
Metal
Roof Updated?
Yes
No
If Yes, Year Roof was Updated
Is the Business in a Brush Area?
Yes
No
Is there Storage more than 1500 Sq Ft?
Yes
No
Are there Smoke Detectors at this Location?
Yes
No
Fire Extinguisher?
Yes
No
Deadbolts on All Doors?
Yes
No
Circuit Breakers?
Yes
No
Electrical Updated?
Yes
No
Heating - Air Conditioning, Thermostatically Controlled?
Yes
No
Heating - Air Conditioning, Central?
Yes
No
Plumbing Updated?
Yes
No
If Yes, Year Plumbing was Updated
Interior Automatic Fire Sprinklers
None
Partial
Full
Theft Alarm
None
Local
Central
Fire Alarm
None
Local
Central
Any Restaurants in your Building?
Yes
No
Any Restaurants in your Building "Next to Your Business"?
Yes
No
Claim Information
How many Losses-Claims in the last 5 years
If yes, Date, Amount Paid and Description of
Each
Loss-Claim
Coverage Information
Current Insurance Company
How much are You Paying Now?
Liability Limit Requested
$100,000
$200,000
$300,000
$500,000
$1,000,000
Building Limit Requested
Building Deductible Requested
Business Personal Property (Contents) Limit Requested
Contents Deductible Requested
$250
$500
$1,000
$2,500
$5,000
Loss Of Income Limit Requested
Additional Comments:
How did you hear about NBP?
Select one
Browsing Internet
Commercial Mortgage Insight
Multifamily Executive
Word of Mouth - Please specify.
Other - Please specify.