Commercial Lines Questionnaire Alabama and Georgia Businesses ONLY This is a general business questionnaire. We will review the questionnaire before we contact you so we may better understand your business and your insurance needs. Company Name: Your Name & Title: Address: City: State: Zip Code: County: Work Phone: Fax: E-Mail Address: Company Web Site: Age of Insured: Business Information Type of Business Ownership: Select Corporation Limited Liability Corporation Individual Partnership Joint Venture Subchapter S Corp. Not For Profit Organization Other Proposed Effective Date: Proposed Expiration Date: Number of Years in Business: Indicate Types of Coverages Applicable: Property Glass and Sign Valuable Papers Crime Transportation Equipment Floater Installation/Builders Risk Electronic Data Commercial General Liability Business Auto Truckers Garage and Dealers Vehicle Schedule Boiler and Machinery Workers Compensation Umbrella Health Number of Locations: Nature of Business (Description of Operations) Use this area for any special comments or coverages which need special attention.
Commercial Lines Questionnaire Alabama and Georgia Businesses ONLY
This is a general business questionnaire. We will review the questionnaire before we contact you so we may better understand your business and your insurance needs.
Type of Business Ownership: Select Corporation Limited Liability Corporation Individual Partnership Joint Venture Subchapter S Corp. Not For Profit Organization Other Proposed Effective Date: Proposed Expiration Date: Number of Years in Business: Indicate Types of Coverages Applicable:
Property Glass and Sign Valuable Papers Crime Transportation Equipment Floater Installation/Builders Risk Electronic Data Commercial General Liability Business Auto Truckers Garage and Dealers Vehicle Schedule Boiler and Machinery Workers Compensation Umbrella Health
Number of Locations: Nature of Business (Description of Operations) Use this area for any special comments or coverages which need special attention.
