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Commercial Property Information Form
Legal Company Name (As filed with the state)
DBA Company Name
Company Type
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C-Corporation
S-Corporation
LLC
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LLP
Joint Venture
Not For Profit
Association
Contact Name
Company Phone Number
Contact Mobile Phone Number
Company Address
Company Website
Company FEIN or Tax ID
NAICS or SIC Code
Year Business Founded
Requested Effective Date of Policy(s)
How Many Owners In The Business?
Do You Own The Building? (If yes: 1- Do you want Replacement Cost, Actual Cash Value, Functional Replacement Cost 2- Most recent Year of Improvements For HVAC, Wiring, Plumbing, Roof (Complete or Partial Replacement?)
Building Construction Year
Total SF of Building
SF You Occupy
Other Businesses in Building? (If yes, types of businesses)
Is The Building Sprinklered? (If yes, what % of the building?)
Do You Have a Burglar Alarm System Installed? (If yes, then name the company who monitors the system)
Do You Have a Fire Alarm System Installed? (If yes, then name the company who monitors the system, Does the system have Manual and/or Automatic)
Current Approximate Premium
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