Business Liability only – No Property Coverage Legal Name of your business: Name(s) of business owners Your email address: Best phone number to call you at:Your website address: Your business location/ mailing address: How many years have you been in business: How many years of similar business experience: Is this your first time getting insurance for this company? Yes No, i have current insurance and will email a copy. I've had insurance a few years ago Please upload a copy of your current or last Insurance policy you have?Max. file size: 10 MB.File must be 10 MB or less If you've had any losses or insurance claims in the last 5 years, please outline: date of loss, amount paid out by insurance company and what happened:Description of your business operations:Your best estimate of your annual gross revenue for the next 12 months: Some insurers offer a discount based on an owner's credit. Do you consent for the insurer to perform a soft credit check? Yes No For the Credit Scoring discount, please type your home address , date of birth and first and last name below (must be at least 30% owner) Where are your customers located ? Please indicate below best breakdown of your gross revenue: 100% local BC 90% BC , 10% rest of Canada 95% Canadian , 5% USA Mostly Canadian and more than 5% USA Mostly Canadian , Some USA and Some Foreign. Do you use any sub-trades or sub-contractors in your business? If so, please outline what operations you "sub out" and approx. percentage of your total gross revenue?Please list below which of the following you do and/or sub out to others and briefly outline scope of work: building demolition, Drilling, Welding, Blasting, spraying Pressure Washing and/or spraying Paint, Spraying (Pesticides), work at Airport Premises, Excavation Work (Maximum Depth?) Propane Work, Ships or Docks, roofing work, Shoring/ Tunneling/ Underpinning, Insulation (Installation/removal) Swimming Pools, Work Cranes, Bridge Work.How many employees do you have on payroll? What is your annual payroll $? Do you require any off premises property coverage to cover any business contents? Are you interested a Cyber/privacy/breach policy to protect your data? Yes No Which liability limit did you want quotes on: $1million $2million $3milliion $4million $5million Greater than $5million How did you find out about our office? I am already an existing customer I am a client of one of your staff members I found you via social media I found you driving/walking by I was referred by someone I found you via google search EmailThis field is for validation purposes and should be left unchanged.
