Utilize our One-Step Online Quote Request Forms to get a pricing indication for your insurance need.



COMMERCIAL BUILDING QUOTE
Please fully complete the following data form, and simply click the "Submit" button and we will contact you with an insurance quotation.

Please note we cannot accept binders or policy changes by email, only by phone during normal working hours.



COMMERCIAL BUILDING INSURANCE

 

First Name:
Last Name:
Email Address:
Mailing Address:
Mailing City:
Mailing State:
Mailing Zip Code:
Phone Number:
Fax Number:
PROPERTY INFORMATION
Property Address:

Property City:
Property State:
Property Zip Code:
How Many Units In The Building?
How Many Units In The Building Are Vacant?
Year Built:
Date You Purchased The Property:
Construction Type:
  
How Many Stories:
If Two Stories, Ground Floor Square Footage:  
Total Square Footage of The Building:  
Is There A Basement?
 yes  no  
Garage Description:
  
Roof Type:
  
Roof Updated:
 yes no  
If Yes, Year Roof was Updated:
Does The Dwelling Have A Pool?
 yes  no  
If Pool, Is It Fenced?
 yes  no  
If Pool, Is There A Diving Board?
 yes  no  
If Pool, Is There A Slide?
 yes  no  
Protection Distance:
Is The Building in the Brush?
 yes  no  
Is there a Brush Hazard within (1) mile of The Building?
 yes no  
If yes, has the Brush been cleared by 250 feet from all sides of The Building?
 yes no  
Smoke Alarm:
 yes no
Fire Extinguisher:
 yes no  
Deadbolts:
 yes no
Electrical Updated:
Circuit Breakers:
 yes no
Does The Electrical Circuit Box Have Copper Wiring?
 yes no
Heating - Air Conditioning, How Old?:
Heating - Air Conditioning, Thermostatically Controlled?:
 yes no 
Energy Source: 
Heating - Air Conditioning, Central?
 yes no 
Has The Plumbing Been Updated?
 yes no
If Yes, Year Plumbing was Updated:
Copper Plumbing:
 yes no  
Does the Building Have Interior Automatic Fire Sprinklers? 
Theft Alarm:
Fire Alarm:
Earthquake Zone:
Earthquake Retrofitted: 
  
Fire District:
Current Insurance Company:
Any Dogs on the Property:
 yes no
If Yes, Number & the Breed of Each Dog:
  
Any Other Pets-Animals on the Property:
 yes no  
If Yes, Number & Description of Each Pet-Animal:
Losses-Claims in the last 5 years: 
  
If Yes, Date, Amount Paid & Description of Each Loss-Claim
COVERAGE INFORMATION

Dwelling Amount (Coverage A):

Other Structures (Coverage B):
Business Property (Coverage C):
Loss of Use (Coverage D):
Premise Liability (Coverage E):
Policy Deductible:
If Earthquake Insurance is Requested, Select Deductible Percentage %:
  
Building Replacement Cost Coverage: 
 yes no  

Please press the Submit Button ONCE.
Then wait for online confirmation of your request.
Thank you for your interest.




17821 E 17th St, Suite 100, Tustin, CA 92780 :: LICENSE #0543173