Business Insurance

DON'T GET CAUGHT UNINSURED OR UNDERINSURED! For a business many different types of insurance exist, including property insurance, liability, commercial auto, workers compensation, group health, life, disability income, "key man" insurance and others. Below are some of the more common types of coverage available, however this is not a complete list and, as always, we recommend you contact us to thoroughly review the needs of your business. Go to our ONLINE QUOTE FORMS below to submit a quote form. Business Owners Policy Workers Compensation • Business Owners Policy • Workers Compensation Insurance Property & Liability Insurance Commercial Vehicle Insurance • Property Insurance • Liability Insurance • Business Interruption • Excess Liability / Commercial Umbrella • Commercial Automobile • Fleet Commercial Automobile • Garage Automobile • Non-Owned Automobile Specialty Liability Miscellaneous Commercial Insurance • Professional Liability • Errors & Omissions Liability • Directors and Officers Liability • Pollution Liability • Marine Liability • Ocean Marine / Hull & Cargo • Boiler & Machinery • Crime • Libel & Slander • Special Event Business Life Insurance, Disability & Benefits • Disability Insurance • Funding of Buy-Sell Agreements • Key Man Coverage • Group Benefits

Business Insurance Quote

Business Insurance Quote No coverage is bound until you are contacted by one of our representatives  Name    Business Name    Street Address    Street Address    City, State, Zip    Phone Numbers   Home     Work   Email Address    BUSINESS ACTIVITIES  1. Type of organization   Select One Corporation Individual Limited Liability Corp. Non-Profit Partnership 'S' Corporation  2. How many owners, partners, or officers?    3. How many employees, excluding owners,      partners or officers?    4. Date Business Started?    5. Last year's payroll:    6. This year's projected payroll:    7. Last year's gross sales:    8. This year's projected sales:    9. Describe your normal business activities      10. Have you had liability losses or claims in        the past 5 years?   Select One Yes No      If yes, please give description, date and amount paid for each      PROPERTY INFORMATION  a. Year Building was built    b. Type of building construction:   Select One Frame Masonry Aluminum Siding  c. Number of Stories    d. Other Occupancies:    e. Total Square Feet    f. Square Feet You Occupy    IF THE BUILDING IS OVER 25 YEARS OLD, PLEASE ANSWER THE FOLLOWING:  f. Year Electricity was Updated    g. Is it on Circuit Breakers   Select One Yes No  h. Year Plumbing was Updated    i. Copper or Galvanized Plumbing   Select One Copper Galvanized Other   If Other  PROTECTIVE DEVICES:  22. Do you have a security system? Select One Yes No       If yes, please describe what type       Burgler Alarm Select One Yes No       Type of Alarm       Alarm Company       Sprinkler System In Building Select One Yes No       Smoke Detectors Select One Yes No  23. Have you had any property losses in the        past 3 years? Select One Yes No       If yes, please describe  PRIOR COVERAGE  1. Previous Carrier  2. Policy Number  3. Prior Premium            $  4. Policy Renewal Date  5. Continuous Coverage      in Force Since  DESIRED COVERAGE       Liability     Coverage Limit:       Property    Coverage Limit:    Deductible:       Buildings    Coverage Limit:    Deductible:       Contents    Coverage Limit:    Deductible:       Signs         Coverage Limit:    Deductible:       Other        If Other:      Coverage Limit:       Other        If Other:      Coverage Limit:       Other        If Other:      Coverage Limit:  ADDITIONAL INSURED  Name    Address    Phone Number   Phone  FAX  Account or Loan #    LIENHOLDER/MORTGAGE INFO  Name    Address    Phone #    Fax #    Loan #    Legal Description    Building Owned or  Leased   Select One Owned Leased  COMMENTS

General Liability Quote

BUSINESS OWNERS PROGRAM General Liabilty Quote 1 Contact Information Contact Name: Name of Business Address: Address 2: City - St - Zip: Phone Number:       FAX E-Mail Address: 2 Desired Limits: (Each Occurrence / General Aggregate) (other limits may be available upon request) $300,000/$550,000 $500,000/$1,000,000 $1,000,000/$2,000,000     3 What percentage, if any, of gross receipts/revenues is derived from service and/or installation of products? 4 \What percentage, if any, of gross receipts/revenues is derived from the rental of any equipment? 5 Please indicate whether any of the following optional coverages are desired: (the limits provided will be the same as the limits chosen in number 1 above).   Employee Benefits Liability YES NO   Liquor Liability YES NO   If yes, please provide annual Liquor Receipts $   Hired and Non-owned Auto Liability YES NO   Stop Gap Liability (ND, OH, WA, WV and WY only) YES NO   Limited International General Liability Extension Endorsement YES NO 6 Please indicate whether any of the following exclusions are desired. a) General Liability Enhancement Endorsement (adds additional insureds and other broadening coverages).   YES NO b) General Liability Extended Enhancement Endorsement (adds extended property damage and other broadening coverages). YES NO Wholesale Applicants ONLY 7 Are all goods manufactured domestically or by a company with a location in the US? YES NO   AIf no, is Imported Products Liability Coverage desired? YES NO If Imported Products Liability Coverage is desired, what are the gross annual sales for foreign manufactured products? $ 8 Do you do any repackaging, re-labeling, repair or re-manufacturing of products? YES NO

Property Insurance Quote

BUSINESS OWNERS PROGRAM Property Insurance Quote 1 Contact Information   Name of Business   Contact Name:   Address:   Address 2:   City - St - Zip:   Phone Number:       FAX   E-Mail Address: 2 Location for this quote.(Address)   Please answer these questions based on your primary location and building. If you have additional locations or buildings, please submit another copy of this section and answer the questions for your other property. Home based businesses should complete the following questions based on the business portion of the home. 3 What is the desired Property Deductible? $500 $1,000 $5,000 $10,000     4 Is the business within 1,000 feet of a fire hydrant? YES NO 5 Is the business within 5 miles of a Fire Station? YES NO 6 What is the 100% replacement value of the business personal property (including business contents, fine arts, value of all computer hardware and software and laptops)?  $ 7 What is the construction of the building where the business is located? Frame (wood) Joisted masonry (brick) Non-combustible (steel) Masonry non-combustible (tilt-up concrete) Fire resistive If the construction of the building is not known, please provide details on the materials used for the roof, floors and walls. 8 What is the square footage of the space occupied by the business? 9 Is the business the sole occupant of a free standing building? YES NO 10 Does the building have an automatic sprinkler system covering 100% of the premises? YES NO 11 Does the business have a central station burglar alarm? YES NO 12 Is there any use of grills or deep fat frying in your business operations or in any other businesses in your building? (i.e. restaurant in the same building) YES NO 13 Please indicate whether the following optional coverages are desired: a) Earthquake Coverage (not available in all areas): YES NO   b) Sprinkler Leakage - Earthquake YES NO   c) Flood Coverage (not available in all areas): YES NO   d) Computer Mechanical Failure and Computer Virus Coverage ($100,000 limit) YES NO   e) Systems Breakdown Coverage? (i.e. boilers, pressure vessels, AC units, etc. YES NO   f) Mine Subsidence Coverage (KY, IL, IN, WV only) YES NO   g) Business Income from Dependent Properties ($10,000 limit) YES NO   h) Personal Property Off Premises and Property in Transit Limited International Extension Endorsement YES NO   i) Business Income Sub-limit YES NO If yes, choose limit option desired: $100,000 $200,000 $300,000 $400,000 $500,000     j) Business Income Waiting Period Deductible (24 hours) YES NO   k) Business Income Off Premises Power Failure ($10,000 limit) YES NO 14 Please indicate whether any of the following exclusions are desired: a) Business Income Exclusion YES NO b) Theft Exclusion YES NO c) Windstorm and Hail Exclusion YES NO d) Stock Exclusion YES NO 15 What is the total maximum daily value of money and securities (i.e. checks) on the premises? The policy includes limits of $10,000 inside the business and $2,000 while being delivered to the bank. If higher limits are desired, choose one of the following options: (Please note that in order to receive higher limits use of a safe on premises is required.) $20,000 / $4,000 $30,000 / $6,000 $40,000 / $8,000 $50,000 / $10,000 16 If loss of refrigeration coverage is desired, please provide the total value of property subject to refrigeration? 17 Many property coverage forms provide for coverage similar to the limits below. If you require higher limits than listed please list below. Separate Limits for Each Coverage (unless you choose a blanket limit): Fire Dept. Service Charge/ Fire Extinguisher Recharge $2,500 Money Orders and Counterfeit Currency $2,500 Forgery and Alteration $2,500 Increased Construction Cost (after a loss) $5,000 Glass $2,500 Signs $2,500 Customers’ Goods on Premises $10,000 Back-up of Sewer/Drains $2,500 Personal Property Off Premises $5,000 Property In Transit $5,000 Valuable Papers/Records on premises $10,000 Accounts Receivable at the premises $10,000 Employees Dishonesty - ERISA $2,500     Indicate coverage area where you will require limits higher than shown above:   Complete the following questions only if interested in purchasing insurance for the building. Home based businesses do not need to complete these questions. 18 What is the 100% replacement value of the building? 19 Are you interested in having one blanket limit for both building and business personal property? YES NO 20 What is the square footage of the entire building? 21 How many stories in the building? 22 What is the original year the building was built? 23 If the building(s) is over 30 years old, indicate the year each of the following was updated: Electrical Roofing Plumbing Heating

Garage Owners Insurance Quote

GARAGE OWNERS INSURANCE QUOTE Contact Information 1 Contact Name: Business Trade Name: Mailing Address: Address 2: City - St - Zip: Phone Number:       FAX E-Mail Address: 2 Years In Business: 3 Years Sales/Repair Experience: 4 Business Entity: Individual Partnership Corporation 5 Describe your Operations: 6 Locations where you conduct Garage Operations:  Location 1: Location 2: Underwritting Information List of Drivers (Owners, Employees, Family) 7 Name   Drivers License State of License: Date of Birth Month January February March April May June July August September October November December Day 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Year 1900 1901 1902 1903 1904 1905 1906 1907 1908 1909 1910 1911 1912 1913 1914 1915 1916 1917 1918 1919 1920 1921 1922 1923 1924 1925 1926 1927 1928 1929 1930 1931 1932 1933 1934 1935 1936 1937 1938 1939 1940 1941 1942 1943 1944 1945 1946 1947 1948 1949 1950 1951 1952 1953 1954 1955 1956 1957 1958 1959 1960 1961 1962 1963 1964 1965 1966 1967 1968 1969 1970 1971 1972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 Furnished Auto:YES NO Job Description and / or Relation: Past 3 Years Number of:   Accidents : Citations: 8 Name   Drivers License State of License: Date of Birth Month January February March April May June July August September October November December Day 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Year 1900 1901 1902 1903 1904 1905 1906 1907 1908 1909 1910 1911 1912 1913 1914 1915 1916 1917 1918 1919 1920 1921 1922 1923 1924 1925 1926 1927 1928 1929 1930 1931 1932 1933 1934 1935 1936 1937 1938 1939 1940 1941 1942 1943 1944 1945 1946 1947 1948 1949 1950 1951 1952 1953 1954 1955 1956 1957 1958 1959 1960 1961 1962 1963 1964 1965 1966 1967 1968 1969 1970 1971 1972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 Furnished Auto:YES NO Job Description and / or Relation: Past 3 Years Number of:   Accidents : Citations: 9 Name   Drivers License State of License: Date of Birth Month January February March April May June July August September October November December Day 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Year 1900 1901 1902 1903 1904 1905 1906 1907 1908 1909 1910 1911 1912 1913 1914 1915 1916 1917 1918 1919 1920 1921 1922 1923 1924 1925 1926 1927 1928 1929 1930 1931 1932 1933 1934 1935 1936 1937 1938 1939 1940 1941 1942 1943 1944 1945 1946 1947 1948 1949 1950 1951 1952 1953 1954 1955 1956 1957 1958 1959 1960 1961 1962 1963 1964 1965 1966 1967 1968 1969 1970 1971 1972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 Furnished Auto:YES NO Job Description and / or Relation: Past 3 Years Number of:   Accidents : Citations: 10 Name   Drivers License State of License: Date of Birth Month January February March April May June July August September October November December Day 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Year 1900 1901 1902 1903 1904 1905 1906 1907 1908 1909 1910 1911 1912 1913 1914 1915 1916 1917 1918 1919 1920 1921 1922 1923 1924 1925 1926 1927 1928 1929 1930 1931 1932 1933 1934 1935 1936 1937 1938 1939 1940 1941 1942 1943 1944 1945 1946 1947 1948 1949 1950 1951 1952 1953 1954 1955 1956 1957 1958 1959 1960 1961 1962 1963 1964 1965 1966 1967 1968 1969 1970 1971 1972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 Furnished Auto:YES NO Job Description and / or Relation: Past 3 Years Number of:   Accidents : Citations: 11 Name   Drivers License State of License: Date of Birth Month January February March April May June July August September October November December Day 1 2 3 4 5 6 7 8<