Some types of commerical insurance policies are highly specialized to the particular industry of the business.  This quote request form only obtains some basic necessary information about your business, but a separate application specific to your particular business may also be required.  Please complete our online questionnaire below (or a PDF verison can be found here), and we will contact you with any additional questions or applications necessary to obtain a quote for your business.

Please note: the information that you provide in this questionnaire will be used to determine your premiums and eligibility for insurance, and you are responsible for the accuracy of the answers you provide.  If you falsely describe or fraudulently omit any fact that is material to the insurance company in order for it to be able to judge the risk, your insurance policy may be void.  Please ensure that you fully understand the answers that you are providing when completing this questionnaire; if you are unsure of some of these details, we strongly recommend that you obtain  professional advice.  You are welcome to contact our office with any questions you have about this questionnaire.

How is this business structured?:

Gross receipts means total income BEFORE expenses are deducted. If this is a new venture, please indicate your estimate for the next 12 months
Has insurance ever been denied or cancelled:
Have there been any losses or claims in the last 5 years:
Have you had any business insurance in the past:
Do you own or rent your location:
Are you the only occupant/tenant of the building:
Is the building sprinklered:
Is there a fire hydrant within 500 ft. (150 metres):
Is there a fire hall within 3 miles (5 kms):
Which coverages are you interested in obtaining (indicate all that apply):

Security code:

Please note, email is not a secure method of transmitting sensitive personal information and by using this service you accept this risk. If you are concerned, you may use an alternative method.