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商業保險估價 Commercial Insurance Quote
守護您的事業,穩健每一步!
Protect your business, grow with confidence!
公司名稱 Company Name
*
公司類型 company is?
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公司經營別稱 DBA:
聯絡人姓名 Contact Name
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電郵 Email
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電話 Phone
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聯邦雇主識別號碼 (FEIN)
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公司地址 Company Address
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選擇辦公室 Select Office
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您偏好的溝通語言 Preferred Language
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郵寄地址 (如果與公司地址不同) Mailing address, if different from company address
業務性質 / 主要業務活動 Nature of business / Primary business activities
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開始經營年份 Business Started
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員工數量 Number of employees
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預估營業額 Estimate Gross Sales
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需要新估價的原因 Reason for New Quote
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您是如何得知我們的?How did you hear about us?
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老闆姓名及生日 Owners' Name & Birthday
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希望的保單生效日期 Desired policy effective date
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目前是否已承保? 哪間保險公司? 到期日? Currently insured? which company? expiration date?
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請上傳目前保險的保單證明文件 Please upload a copy of the current insurance's declaration page
Upload File
請上傳過去五年保單事故紀錄 Please upload 5 year Loss Run Report.
Upload File
是否曾有事故紀錄 Any known prior claim?
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若曾有事故請寫下年份及描述事故 Please provide the year and a brief description of any past incidents or claims:
建築面積(平方呎)Building size (square footage)
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建築年份 Year built
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建築物是否自有或租用 Is the building owned or leased?
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需保財產類型與估值(設備、貨品、存貨等)Property to be insured and value (equipment, inventory, etc.)
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需保室內裝潢估值 Valuation of Tenant Improvements and Betterments required for insurance purposes
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有無更新過(電線、水管、屋頂、冷暖氣)Any updates (electrical, plumbing, roof, HVAC)?
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屋頂更新年份 Roof Update Year
水管更新年份 Plumbing Update Year
電線更新年份 Wiring Update Year
冷暖氣更新年份 HVAC Update Year
是否有防盜警報 Burglar Alarm?
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是否有防火警報 Fire Alarm?
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是否有灑水系統 Sprinkler?
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是否有保全系統 Security System?
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電箱種類是否為 Is the electric panel Zinsco (GTE-Sylvania), Federal Pacific Electric (FPE), Challenger (Eaton/Cutler Hammer), Pushmatic or Fuse Box?
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請提供一張電箱的照片 Please provide a photo of the electric panel.
*
Upload File
是否需要向房東、銀行或是客戶提供保險證明(COI)?Do you need to issue a Certificate of Insurance (COI) to landlord, bank, or vendor?
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請提供完整的資料 Please provide complete information
或直接上傳要求文件 Or upload the requirement directly
Upload File
是否需要分公司或其他地點的保障?若是,請提供地址 Any additional insured locations or branches? If Yes, please provide address
若是餐廳,請提供過去四個季度的銷售稅報表 For restaurant, please provide the sales tax reports for the previous four quarters.
Upload File
備註 Notes
Submit
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