Business Owner's Policy

Many small business owners buy a type of insurance coverage called a Business Owner's Policy.

This is a package policy that covers major property and liability exposures as well as a loss of income if your business cannot operate for a period of time. For example, if your firm's roof is damaged during a thunderstorm, causing your office to flood and your business to close for two months, a BOP would provide coverage in several ways. The policy would cover the cost of repairing the roof, cleaning up water damage and repairing or replacing your furniture, computers and supplies. A BOP also would cover your payroll and taxes for the two months the business was closed. And if one of your clients was in your office during the storm and was injured by falling debris, a BOP would cover your customer's medical bills.

General Information
Name of Insured
Address
City
State
Zip
Business Phone
Fax Number
Email Address
Location Address (type "same" if same as above)
City
State
Zip

Property Questions
Age of building / Year Built	Type of building construction	Number of stories	Other occupancies	Square feet you occupy

If the building is over 25 years old, please answer the following:
Year Electricity was updated
Is it on circuit breakers?		Yes No
Year Plumbing was updated
Copper or Galvanized plumbing?		Copper Galvanized Other:
Year Building was last re-roofed
Type of roofing material
Type of heating system in the building

Protective Devices
Burglar Alarm	Central Station or local alarm?	Name of alarm company	Is the building sprinklered?	Are there smoke detectors?
Yes No	Central Station Local Alarm		Yes No	Yes No

Liability Questions
Please provide information on previous insurance carrier:
Previous Ins. Carrier	Policy number	Prior premium	Policy renewal date
		$
Please provide information about your business:
Years in business	Projected Gross annual receipts		Projected annual payroll
	$		$
Describe your business, product or service:

Coverage Limits
Building	Contents (equipment, inventory, supplies, etc.)		Deductible	Loss of Income
$	$			$
Money and Securities	Glass or signs	General Liability Limit	Non-owned and Hired Automobile Liability	Is liquor liability needed?
$	$		$	Yes No
If Glass Coverage is needed, please provide dimensions:
Please list other coverages you may need:

Miscellaneous Information
Name of Additional Insured (Landlord or vendor)
Mailing Address
City
State
Zip

Additional Comments

Please give any additional comments you feel appropriate for this quotation. If you have additional information where there was not enough fields above, please enter them here.




Premier One offers insurance products and services through its licensed affiliate Premier One Insurance Services, Inc. (Licenses), Insurealty Insurance Services, and other affiliates. Insurance products and services are provided by insurance companies and similar providers. Rates and coverage are subject to individual qualification. Not all products are available in all states.

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