1594 N. Batavia Street
Orange, CA 92867
(714) 524-4949 Office
(714) 524-4940 Fax

Business Earthquake Insurance

Posted on | May 30, 2011 | No Comments


1. Vesting/Ownership (Name as it will appear on the policy) (required)

2. Contact Email (required)

 

3. Contact Phone Number (required)

4. Mailing Address (required)

5. Location Address (required)

6. Year Built

 

7. Square Footage (building area only, not garage)?

8. Construction Type (Frame, Reinforced Concrete Block, Tilt-Up, other-please specify)

9. Number of Buildings

 

10. Number of Stories?

 

11. Number of Units?

12. Occupancy Type per Building (Apartments, Commercial, etc)

13. Type of Parking

Garages or Carports

 

Attached or Detached

(if attached, please specify if Tuck Under, Subterranean, or Under-Building)



14. Any prior earthquake claims? if yes, describe the loss(es), list the amount paid and date of loss:

15. Building Limit:
$

 

16. Amount of annual rent
$

17. Personal Property (if any: rental office, furnished units ...)
$

18. Current Carrier:

 

19. Expiration Date:

20. General Message

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