Name: Britton and Britton Insurance
Address: 700 Lavaca St #1400, Austin, TX, 78701

Business, Property or Liability Insurance

Simply fill in the following information and a Britton & Britton agent will contact you personally with more information.

Business Start-Date*
Date Format: 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?*
Please describe*
Are clients or employees permitted in your home or residence?*
Is this business or property currently insured?*
What is the expiration date?
Date Format: MM slash DD slash YYYY
Did your prior policy cancel or non-renewal in the past 5 years?*
If so, why?*
Have there been claims in the past 5 years?*
If yes, please describe including date and amount paid out:*

General Liability?
Business owner policy (BOP)?
Liability Amount
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?*
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?*
Is this business a restaurant?*
Is this business a food truck or food trailer?*
Golf Course Questions
Is the Golf Club:*
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?*
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?*