Commercial Business Insurance

* indicates a required field

Corporate Legal Name: *

Year Established: *

Mailing Address: *

Email: *

Telephone: *

Business Description: *

Current Insurer:

Renewal Date:

Your target premium price (excluding PST:)

A. PROPERTY/BUSINESS INTERRUPTION/EQUIPMENT BREAKDOWN INFORMATION

Year built:

No. of storeys


If "Other" please specify:


If "Other" please specify:


If "Other" please specify:


If "Other" please specify:

Square footage:


If "Other" please specify:


None
Burglary
Local alarm
Central station monitored alarm
Fenced yard
Metal bars or grills protecting all glass / windows

Coverages (Indicated Insured Limits):















B. LIABILITY/CRIME INFORMATION

Annual Revenue:







C. CLAIMS INFO

What measures have you taken to avoid similar claims:

D. ADDITIONAL INFO/NOTES