Ex: Joan Smith DBA Joanie's Repairs. Will appear on policy.
The legal name is your business's incorporation name, or your legal name if the business is just you. Doing Business As (DBA) is the name you use to market your business.
Primary Location Address
This is the main location your business operates in.
Is your mailing address the same as your business address?
Mailing address
About your ownership structure
What best describes your business's ownership structure?
What year did you start your business?
About your locations
Does your business have any permanent office locations outside of your primary state? Not including home-based locations, projects or job sites.
About your business
Include payroll for all cash workers and 1099 contractors.
About your subcontractors
Do you want to include subcontractor coverage in your policy? Subcontractor coverage covers damage to your work done by your subcontractors.
About your business
Don't include owners or subcontractors. Estimate your business's payroll expense for full-time, part-time, and temporary employees during the next 12 months.
About your business
Do the activities of your subcontractors include: Blasting operations · Man hole work · Work on traffic lights?
About your subcontractors
Do you accept the following requirements of this policy?
Any subcontractors you work with must carry coverage with limits greater than or equal to your own
You must obtain and store a certificate of insurance from each of your subcontractors listing you as an additional insured on their policy
In case of a claim related to your subcontractor, you will not be covered without this documentation
Your subcontractors must have all required licenses before performing work
About your insurance
Have there been any insurance claims filed by or against your business in the past three years?
About your work
Has your commercial insurance coverage been canceled, revoked, or non-renewed in the last 3 years (other than cancellation for non-payment or non-renewal for discontinuation of program)?
Has your business, or any of its officers, owners, or partners:
Been convicted of a felony in the past 5 years?
Declared bankruptcy in the past 3 years?
Had business-related lawsuits, mediations, or arbitrations filed against them?
Become aware of any losses, accidents, or circumstances that might give rise to a claim against this policy?
When would you like your coverage to start?
About your insurance
Would you like to include Umbrella/Excess Liability coverage?
Umbrella/Excess Liability coverage extends the limit of your General Liability coverage.
How much limit did you ask to have for your Umbrella/Excess Liability?
Your selection extends both occurrence and aggregate limits of your General Liability coverage.
About your business
My business is located in:
About your primary location
About your services
About your business property
What is your estimate for the total cost to replace your business property, including existing and planned improvements?
These assets include: kitchen equipment, furniture, decorations, average inventory, electronics, renovations you've made. Remember, this doesn't include the value of the physical building.
About your insurance — Tools and equipment
What's the estimated cost to replace all tools and equipment at your business?
Include the estimated cost of items you regularly use for work such as lawnmower, power tools, safety helmets and hearing protection, etc.
Federal Employer Identification Number (FEIN)
Needed to issue a Workers' Compensation policy.
Employer's Liability Limits
Each Claim / Policy Limit / Each Employee
Deductible
Would you like a waiver of subrogation?
Detailed description of operations
Building coverage limit
If you own the building, what limit would you like? Leave blank if you lease/rent.
Business Personal Property limit
Total value of inventory, furniture, equipment, and electronics at your location.
General Liability limits preference
Property deductible preference
BOP endorsements
Add any optional coverages to your Business Owner's Policy.
Customer foot traffic
How much customer traffic does this location see?
What sensitive data do you collect?
Select all that apply.
How many records do you store?
Approximate count of individual records with sensitive data.
E-commerce activity
What percentage of your revenue comes from online/e-commerce?
Security controls in place
Check all that currently apply to your business. These affect your rate and eligibility.
Backup frequency
How often are backups performed?
Where is your sensitive data stored?
Do you use a third-party IT provider or Managed Service Provider (MSP)?
Do employees access company systems via remote access or VPN?
Do employees use personal devices for work (BYOD)?
Do you store, process, or transmit data internationally?
Payment processing method
Have you experienced a cyber incident or data breach in the last 5 years?
Do you currently have cyber insurance?
Have you ever been declined, or had a cyber policy cancelled or non-renewed?
Desired cyber liability limit
Retention / deductible preference
First-party coverages
These protect your business directly. Select all you'd like quoted.
Third-party coverages
These protect you against claims from others. Select all you'd like quoted.
Review & sign
Acknowledge the terms and sign to submit your quote request.
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