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QUOTE REQUEST - Contact Information |
| Organization Name: |
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First Name: |
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Last Name: |
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Address: |
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City: |
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State: |
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Phone: |
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Zip Code: |
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E-mail: |
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Confirm E-mail: |
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| Website: |
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| Business Type: |
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| Number of
Teachers: |
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Teachers Are:
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| Number of Teachers: |
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| Year Business
Started: |
Year
Dance Experience:
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Square Footage of the space that you use for your
studio: |
(if
known) |
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Do you lease your studio to other businesses or people? |
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| Do you work with special
needs children? |
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| Do you use a waiver? |
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Location: |
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| Average number of
participants in your class: |
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Please indicate the maximum number of students enrolled
last year at the busiest time:
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How many are pilates students?
(or write 0) |
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| Gross
Receipts: |
$
(from tuition and fees, excluding
pilates)
$
(from pilates)
$
(from products that you sell)
New businesses may estimate their gross receipts,
but we need this information to obtain a quote.
Definition of
Gross Receipts
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| Do you make any exercise or
related instructional DVDs or videos? |
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| Do you teach any aerial
arts? |
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COVERAGE OPTIONS |
| General
Liability: |
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Professional Liability: |
This coverage is
quoted automatically when available. Please review your quote when
you receive it. |
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| Abuse and Molestation
Coverage: |
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| Business
Personal Property
(optional): |
$
Enter the amount of equipment coverage that
you would like here, or you can write "none" |
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| Tenant
Improvement Coverage (optional): |
$
Enter the amount of tenant improvement
coverage that you would like here, or you can write "none" |
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| Do you have any other information
about your business, or comments that you would like to
share? Please place special requests here. |
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Do you currently have insurance (if
yes, with which carrier)?
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Current Premium:
(this helps us compare rates)
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Someone will contact you about your insurance request to go over the
coverage and options usually in the same day. |
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NO COVERAGE IS BOUND,
OFFERED, ISSUED THROUGH THIS ELECTRONIC COMMUNICATION, ALL POLICIES MUST BE
UNDERWRITTEN AND APPROVED BY THE CARRIER. DO NOT CANCEL YOUR CURRENT
INSURANCE.
Dance School Insurance,
Ballet School Insurance, Fine Arts School Insurance. Vocational School, Trade
School, Specialty School, Training School Tutor, Educator, School
Insurance
Copyright 2012 Stratum
Insurance Agency, LLC
    
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