Secure Business Owners Policy (BOP) Quote Request Form

A Business Owners Policy bundles property cover and liability cover into a single policy. For most small and mid-size businesses it is the cheapest way to get both, and it is the usual place to start.

Only your name, email and phone are required — fill in what you know and we will come back to you for the rest. Nothing here is an application and nothing is binding.

Your business Business Name

DBA / Trading AsOnly if different from the name above.Business Structure

Business Address

CityZIP Code

Mailing AddressOnly if your mail goes somewhere else.

Your First NameYour Last Name

Email AddressPhone Number

Years in BusinessApproximate Annual RevenueA rough figure is fine.

WebsiteIf you have one.

What your business does Describe Your Operations, Products or Services

Do You Operate From This Location Only?

If No, List Your Other Locations

Do You Hire Subcontractors?Full-Time Employees

Part-Time EmployeesTotal Annual Payroll

Your building

Do You Own or Lease the Building?Year the Building Was Built

Square FootageConstruction Type

Year the Roof Was Last ReplacedYear the Plumbing Was Last Updated

Year the Electrical Was Last UpdatedYear the Heating / Air Was Last Updated

Does the Building Have Fire Sprinklers?Alarm System

Cost to Rebuild the BuildingIf you know it.

What is inside

Value of Furniture, Fixtures and EquipmentValue of Stock or Inventory on Hand

Any Customer Property in Your Care?

Estimated Monthly Gross IncomeUsed to work out cover if a loss shuts you down.

Your current cover and timing Any property or liability claims in the past 5 years?

Current or Previous InsurerIf you are switching or renewing.What You Pay NowIf you know it.

When Do You Need Cover to Start?

Anything Else We Should Know

This is a solicitation for insurance. Completing this form does not apply for or bind cover. Coverage cannot be bound or changed via this form, e-mail, voicemail, text, or facsimile — only by written confirmation from our office.