Business Quote July 19, 2018by Walter Step 1 of 5 20% Date of incorporation?* Date Format: MM slash DD slash YYYY What is the Federal ID number?*What is the exact name of the U.S. entity?*Please list all entities with 51% or greater ownership.List all mailing addresses (distinguish billing if it is different)?*Designated Contact Person* Mr.Mrs.MissMs.Dr.Prof.Rev. Prefix First Last Email* Phone*Fax*Website* Property QuestionsWhat is the non-depreciated value of company assets (per location if applicable)?Are there foreign locations? Yes No Please provide the following building detail: Square footage?Sprinklered? Yes No Fire Alarm? Yes No Burglar Alarm? Yes No Building type (frame, brick, etc.)? AutomobileDoes the company own any automobiles?YesNoYear/Make/VinWhere are the automobiles garaged?Driver info: D.O.B Date Format: MM slash DD slash YYYY Driver info: SS#?Please detail any losses.Do you plan to rent automobiles?YesNoEstimated number of rental days. What are the annual projected sales?Please provide a description of your product or service?Be specific, but try to keep it simple possible Workers' Comp QuestionsPlease cap officers (determined in company charter) at $57,200 each.ClericalSalesOtherPlease describe the job/duties.Payroll AmountHow many employees are there?Is there any foreign travel?YesNoNumber of tripsTypical destinations?Upload Your Current Policy Declaration Pages Drop files here or Accepted file types: jpg, gif, png, pdf. CAPTCHA This iframe contains the logic required to handle Ajax powered Gravity Forms.
