Britton and Britton Insurance
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512-469-0693
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210-493-4057
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Business, Property or Liability Insurance
Simply fill in the following information and a Britton & Britton agent will contact you personally with more information.
Step
1
of
4
25%
Name
*
First
Last
Business Name or Owner
*
Location
*
Street Address
City
ZIP Code
Square ft. Occupied
*
Exterior Construction
*
Year Built
*
Are you the building owner or a tenant?
*
Owner
Tenant
Do you have a security system, monitoring, or reporting?
*
Security System
Monitoring
Reporting
None
Do you have multiple locations or buildings?
No
Yes
Business Location Address 2
*
Street Address
City
ZIP Code
Square ft. Occupied
*
Exterior Construction
*
Year Built
*
Are you the building owner or a tenant?
*
Owner
Tenant
Do you have a security system, monitoring, or reporting?
*
Security System
Monitoring
Reporting
None
Business Location Address 3
Street Address
City
ZIP Code
Square ft. Occupied
Exterior Construction
Year Built
Are you the building owner or a tenant?
Owner
Tenant
Do you have a security system, monitoring, or reporting?
Security System
Monitoring
Reporting
None
Business Location Address 4
Street Address
City
ZIP Code
Square ft. Occupied
Exterior Construction
Year Built
Are you the building owner or a tenant?
Owner
Tenant
Do you have a security system, monitoring, or reporting?
Security System
Monitoring
Reporting
None
Mailing Address
*
Same as previous
Street Address
City
ZIP Code
Website
Phone
*
Email
*
Please note we will never sell your email address.
Business Start-Date
*
MM slash DD slash YYYY
Total # of years experience in industry
*
Business Description
*
Provide a short description of your business, services, and products.
Is this a home-based business?
*
Yes
No
Please describe
*
Are clients or employees permitted in your home or residence?
*
Yes
No
Is this business or property currently insured?
*
Yes
No
What is the expiration date?
MM slash DD slash YYYY
Did your prior policy cancel or non-renewal in the past 5 years?
*
Yes
No
If so, why?
*
Have there been claims in the past 5 years?
*
Yes
No
If yes, please describe including date and amount paid out:
*
General Liability?
Yes
No
Business owner policy (BOP)?
Yes
No
Liability Amount
$1 Million
$2 Million
$4 Million
Not sure
Other
Number of principle owners
*
Please enter a number from
1
to
100
.
Estimate annual gross sales or revenue
*
Estimate annual payroll employees
*
Does the landlord or another entity need to be listed as additional insured?
*
Yes
No
Name
*
First
Last
Address
*
Street Address
City
State / Province / Region
ZIP / Postal Code
Phone
*
Please describe any contract requirements:
Is this business a golf course or country club?
*
Yes
No
Is this business a restaurant?
*
Yes
No
Is this business a food truck or food trailer?
*
Yes
No
Golf Course Questions
Is the Golf Club:
*
Public
Private
Semi-private
Estimate Annual Sales from Member dues and initiation fees
*
Estimate Annual Sales from Green fees, cart fees, other
*
Estimate Annual Sales from HOA Fees
*
Estimate Annual Sales Pro-Shop (if owned)
*
Do you need coverage for the HOA?
*
Yes
No
Number of Rounds played/year (include non-members):
*
Number of members:
*
Number of employees (full time)
*
Number of employees (part time)
*
Number of golf carts:
*
Number of other carts (beverage, range cart)
*
Describe any other amenities or activities (such as Guest Quarters, Fitness Center, Pool, Tournaments):
*
Restaurant Questions
Estimate Annual Sales Food Sales
*
Estimate Annual Sales Liquor Sales
*
Estimate Annual Sales Catering Sales
*
Estimate Annual Sales Delivery Sales
*
Describe any live entertainment, happy hours, promotions or specials
*
Food Truck/Trailer Questions
Year / Make / Model
*
Vehicle ID (VIN), Serial or Model Number
*
Length of Food Truck/Trailer
*
Value of Food Truck/Trailer
*
Value of permanently installed kitchen and equipment
*
How often will the Food truck or trailer be moved per month?
*
Will you serve alcoholic beverages?
*
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