Building Owner's Quote Form for Commercial Liability Insurance

First and Last Name of Owner
Management Company Name
Contact Name
Mailing Address
Phone #
Fax #
E-mail address
Location Reference (“Lincoln Plaza”)
Location Address
Type of Tenant Occupancy
Type of Quote Requested
Year Built
Construction Type
Roof Type
Type of Parking
Is the Building Fully Sprinklered?	No Yes
Number of Buildings
Number of Units
Number of Tenants
Total Square footage of each building
Approximate annual rents
Any losses in the past 4 years?	No Yes
Current Insurance Carrier
Insurance Renewal Date
Is the current carrier offering renewal coverage?	No Yes
If no, please explain
Total Property Limit Requested
Are there any pools?	No Yes

Have there been any updates within the past 30 years?
Electrical	No Yes
Plumbing	No Yes
Roof	No Yes
HVAC	No Yes

Do you currently have EQ coverage?	No Yes

Building Owners » Commercial Liability