BUSINESS OWNERS POLICY QUOTE (BOP)

If you have a current policy, it is often helpful to fax us a copy,
so that we may compare the coverage.
Our fax number is (949) 270-0608.

ABOUT THE OWNER / PRINCIPAL

Company Name:
First Name:
Last Name:
Address:
City:         
State:
Zip Code:
Phone:    
Birthday:
E-mail:
Confirm E-mail:
Home Status:
Gender:

 

 

ABOUT THE BUSINESS

Name of Business:  
Type of Business:  
Description of Business:
Year Started:   Years experience in industry:  
  Space Occupied (sq feet): (location 1)
  Space Occupied (sq feet): (location 2, if any)
  Total building space (sq feet): (location 1)
  Total building space (sq feet): (location 2)
  Stories (location 1): Stories(location 2):
  Year Building Built:
   
Full Time Employees         Part-Time?        
   Number of Partners/Execs:
Smoke Detectors:    Sprinklers:
Tax ID #  
Industry Code   (if known)
   
Liability Limits: $
   
Gross Receipts: $
Annual Income: $
   
Annual Payroll: $
   
       Any cooking on premises?    
       Any roofing?
       Is this a franchise operation?
       In an enclosed shopping mall?
       Any chemical exposure?
       Any armed security guard or dogs?
       Any work performed above 2 stories?
   
Other: Safe on Premises?
  Prior losses or claims?
  Building Security System?
   
   
*** Do you currently have insurance (if yes, with what carrier? 
 
  Current Premium:  
   
  Do you have any other information about your business, or comments that you would like to share? Please place special requests here, such as extra coverage for special items..
 

 
 
 
If you are not sure of exactly what you need, make sure to at least give us a description of your vehicle and we will send you a base quote that we can later adjust to find what is right for you.

 

 

 

 

Why choose us as your insurance broker?

 

 

 

 

 
If you have more than one LOCATION, please tell us about the second car in the additional information section.

 

 

 

Need help?

(949) 270-0609

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

                   

 

Copyright 2009 Stratum Insurance Agency, LLC