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Location & Sales Information:
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Square Footage of office or business location:
Type of Building (masonry, concrete, etc.):
Number of Stories:
Are there other business/residences in this building (describe)?:
Describe safety features (alarm, sprinklers, fire protection, etc):
Coverage Desired: (Check One Please)
Policy Type I am Interested In:
Claims Made Form
Occurrence Form
Limits of Liability Coverage I am Interested In:
$30,000
$50,000
$100,000
$300,000
$1 Million
Limit of Physical Damage needed: (Total amount of "owned" vehicle coverage on lot)
Location #1:
Location #2 (If applicable)
Location #3: (If applicable)
Limit of Garagekeepers Coverage Needed: (Total amount of "non owned" vehicle left in your possession.)
$
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coverage type... we will suggest the best coverage for you - just try to tell us what you are looking for! (If we need more info. we will let you know.)
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