Commercial Quote Sheet

General Liability (Company Will Audit at Expiration)

Payroll

Gross Sales

Total # of Employees

PT/FT (per classification)

Give total number of both Part Time & Full Time Employees

Area (LRO: Need tenant specific details need sq. ft. and description of each tenant occupancy)

Misc Information

Property (Company Will Inspect Property)

Interest in Building (owner, tenant)

Building Occupancy (list all tenants occupancy)

Sq. Footage Occupied (breakdown per tenant)

Total Sq. Footage of Building

Year Built

# of Stories

Construction

If building is older than 20 years, are there any updates? (details of updates)

Heating (year updated)

Wiring (year updated)

Fuse Box

Yes No

Plumbing (year updated)

Roof (year updated)

Roof Material

Building Limits

BPP Limits

ILM

Deductible Information/Misc Information

Workers Comp (Company Will Audit at Expiration)

Total # of Employees

PT/FT

Give total number of both Part Time & Full Time.

Payroll

Class Codes/Description of Jobs of Employees.

Officers Names

Include/Exclude

Exp Mod

Misc Information

Commercial Auto

Liability Limit

UM Limit

Med Pay Limit

Vehicle(s): Year, Make, Model, VIN, GVW, Radius, Usage, Hitch Type, # of Job Sites, Value, Deductibles, Permanently Attached Equipment & Value.

Driver(s): Name as on License, State & License Number, Date of Birth, Any Accident/Violations, CDL - if yes, original date of issue.

Upload an Attachment

Will be sent securely Your request will be sent securely over an SSL-encrypted connection

We respect your privacy. Your information will be sent securely and handled with care. View our privacy policy.

Jack Bradley Agency