Questions?
Ask the Agent! Use the form below
or give us a call.
Phone: (800) 750-8888
Fax: (866) 353-3083
Commercial Property Insurance Quote
One Simple Form - takes only 2-3 Minutes!
YOUR PERSONAL | COMPANY DATA:
Your Name:
Business Name:
Property Address:
City:
State: (Must be California)
Zip/Postal:
E-Mail: (Required)
E-Mail: (Again for accuracy)
Phone:
Fax: (Optional)
Your Company Website:
DWELLING INFOMATION
Year Building Built:
Building Square footage:
Occupancy:
Owner
Tenant
Occupancy Type:
(describe entities & and number of units, such as "4 unit apartment" or "2 offices and barber shop", etc.)
Type foundation:
Slab
Crawlspace over
slab
Pier & Post Other
(list in remarks)
Type finished basement, if any:
None Full 25%
50%
75%
Type Roof:
Shingle Wood Shake
Tar/Gravel Spanish Tile
Metal Other
Type of Siding
Brick
Vinyl
Wood
Aluminum
Number of stories:
One
Two
Three 4 or more
# of feet to nearest fire hydrant:
# of miles to nearest fire station:
Currently Insured?
Yes
No
Name of Carrier & how long insured?
Prior Claims?
Yes
No
Describe claims in detail:
Plumbing type:
Copper
Galvanized
Mixed (Copper/Galvanized)
COVERAGES:
Building Cov. $
Contents $
Liability Cov. $
Deductible $ ($250, $500, $1,000, etc.)
Other Coverage/Remarks (describe any extra coverage needed
such as business interruption, robbery, computers, etc.)
Send my quotation via:
E-Mail Fax Regular Mail
Call Me by Phone
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taken to insure your privacy, security, and our intent is to release quote information only
to you. We will not give your data to ANY other person or group for sales, marketing,
or ANY other purposes. By checking the box below you agree to allow our agency to release this information via the method you have chosen, and to
release us from any liability should this information be accidentally viewed by others.
Our intention is to maintain your complete privacy.
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HAD / Professional Insurance Associates, Inc | Mailing Address: P.O. Box 8480, Porter Ranch, CA 91327
1100 Industrial Road, Suite 3, San Carlos, CA 94070 | 6320 Canoga Avenue, Suite 1500, Woodland Hills, CA 91367
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