Submit Commercial Real Estate Risk

Agent Information

Agent Name

Agency Name

Email

Phone

Insured Information

Insured Name

DBA (if applicable)

Contact Name

Contact Email

Contact Phone

Business Website

Years in Business

FEIN/Tax ID

Mailing Address

City

State

ZIP Code

Property Information

Property Address

Property Type

Year Built

Square Footage

Number of Stories

Type of Tenants

Construction Type

Sprinklered

Alarm System

Roof Type

Year Roof Replaced

Plumbing Type

Year Plumbing Updated

Electrical Type

Year Electrical Updated

Heating Type

Year Heating Updated

Occupancy Rate (%)

Coverage Information

Requested Effective Date

Expiration Date

Building Value ($)

Contents Value ($)

Business Income ($)

Liability Limit ($)

Document Upload

Upload Loss Runs

Drag and drop your loss runs here or click to browse

Upload ACORD Forms

Drag and drop your ACORD forms here or click to browse

Upload Property Photos

Drag and drop your property photos here or click to browse