AMR Insurance - Tacoma, Washington - Business Property Quote

Business Property Quote

Contact Information

Name of Business
Contact Name:
Address:
Mailing Address:
City, State, Zip
Phone Number	Home Work
Email
Location for this quote.(Address)

Questions

Please answer these questions based on your primary location and building. If you have additional locations or buildings, please submit another copy of this section and answer the questions for your other property. Home based businesses should complete the following questions based on the business portion of the home.

What is the desired Property Deductible?

Is the business within 1,000 feet of a fire hydrant?

YES NO

Is the business within 5 miles of a Fire Station?

YES NO

What is the 100% replacement value of the business personal property (including business contents, fine arts, value of all computer hardware and software and laptops)? $

What is the construction of the building where the business is located?

Frame (wood)	Joisted masonry (brick)	Non-combustible (steel)
Masonry non-combustible (tilt-up concrete)		Fire resistive

If the construction of the building is not known, please provide details on the materials used for the roof, floors and walls.

What is the square footage of the space occupied by the business?

Is the business the sole occupant of a free standing building?

YES NO

Does the building have an automatic sprinkler system covering 100% of the premises?

YES NO

Does the business have a central station burglar alarm?

YES NO

Is there any use of grills or deep fat frying in your business operations or in any other businesses in your building? (i.e. restaurant in the same building)

YES NO

Please indicate the following optional coverages that are desired:

a) Earthquake Coverage (not available in all areas):

YES NO

b) Sprinkler Leakage - Earthquake

YES NO

c) Flood Coverage (not available in all areas):

YES NO

d) Computer Mechanical Failure and Computer Virus Coverage ($100,000 limit)

YES NO

e) Systems Breakdown Coverage? (i.e. boilers, pressure vessels, AC units, etc.

YES NO

f) Mine Subsidence Coverage (KY, IL, IN, WV only)

YES NO

g) Business Income from Dependent properties ($10,000 limit)

YES NO

h) Personal Property Off Premises and Property in Transit Limited International Extension Endorsement

YES NO

i) Business Income Sub-limit

YES NO

If yes, choose limit option desired:

$100,000 $200,000 $300,000 $400,000 $500,000

j) Business Income Waiting Period Deductible (24 hours)

YES NO

k) Business Income Off Premises Power Failure ($10,000 limit)

YES NO

Please indicate whether any of the following exclusions are desired:

a) Business Income Exclusion	YES NO
b) Theft Exclusion	YES NO
c) Windstorm and Hail Exclusion	YES NO
d) Stock Exclusion	YES NO
What is the total maximum daily value of money and securities (i.e. checks) on the premises?

The policy includes limits of $10,000 inside the business and $2,000 while being delivered to the bank. If higher limits are desired, choose one of the following options: (Please note that in order to receive higher limits use of a safe on premises is required.)

$20,000 / $4,000 $30,000 / $6,000 $40,000 / $8,000 $50,000 / $10,000

If loss of refrigeration coverage is desired, please provide the total value of property subject to refrigeration?

Many property coverage forms provide for coverage similar to the limits below. If you require higher limits than listed please list below.

Separate Limits for Each Coverage (unless you choose a blanket limit):

Fire Dept. Service Charge/ Fire Extinguisher Recharge	$2,500	Money Orders and Counterfeit Currency	$2,500
Forgery and Alteration	$2,500	Increased Construction Cost (after a loss)	$5,000
Glass	$2,500	Signs	$2,500
Customers’ Goods on Premises	$10,000	Back-up of Sewer/Drains	$2,500
Personal Property Off Premises	$5,000	Property In Transit	$5,000
Valuable Papers/Records on premises	$10,000	Accounts Receivable at the premises	$10,000
Employees Dishonesty - ERISA	$2,500

Indicate coverage area where you will require limits higher than shown above:

Complete the following questions only if interested in purchasing insurance for the building. Home based businesses do not need to complete these questions.

What is the 100% replacement value of the building?

Are you interested in having one blanket limit for both building and business personal property?

YES NO

What is the square footage of the entire building?

How many stories in the building?

What is the original year the building was built?

If the building(s) is over 30 years old, indicate the year each of the following was updated:

Electrical	Roofing	Plumbing	Heating

* Required Fields

Business Property Quote

Contact Information

Questions

Please indicate the following optional coverages that are desired:

Please indicate whether any of the following exclusions are desired:

Separate Limits for Each Coverage (unless you choose a blanket limit):

Complete the following questions only if interested in purchasing insurance for the building. Home based businesses do not need to complete these questions.

Navigation