Commercial Property Quote

NuSurance DOES NOT sale YOUR information, however one of “OUR” Agents may call to secure additional information to provide you with additional discounts and the overall best rate .

. Agent or Location Agent or State or County Georgia - All Counties Florida : Hillsborough County Manatee County Marion County Sarasota County Polk County Pinellas County Pasco County Hernando County Citrus County Taylor County Levy County Other FL County Your Name: Mr. Mrs. Ms.   Business or Corp Name or Name of the Condo Assoc. Mailing Address: City: County: State:    Zip:  Location if Different than mailing address City State ZIP Type Of Business : Work Phone: Cell Phone: e-mail Address: Federal Tax Number Present Insurance Company How Long Insured? Expiration Date Are you an Owner or Tenant? Owner of Building Rent the Building Condo Assoc Mater Policy     Do you have? (Check all that apply) Smoke Alarm Fire Extinguisher Dead Bolts on All Doors Burglar Alarm - Local Burglar Alarm - 24 hour   Have you had any losses in the last 3 years? Yes No       Date Business Started (if NEW Leave Blank) January February March April May June July August September October November December 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 1900 1901 1902 1903 1904 1905 1906 1907 1908 1909 1910 1911 1912 1913 1914 1915 1916 1917 1918 1919 1920 1921 1922 1923 1924 1925 1926 1927 1928 1929 1930 1931 1932 1933 1934 1935 1936 1937 1938 1939 1940 1941 1942 1943 1944 1945 1946 1947 1948 1949 1950 1951 1952 1953 1954 1955 1956 1957 1958 1959 1960 1961 1962 1963 1964 1965 1966 1967 1968 1969 1970 1971 1972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003   Year of Construction?   Type of Structure Go to appropriate fields below. Condo Apartment Commercial Building     Condo or Apartments Total Value Total Square Feet If multifamily, what type? Single Building 1 Floor Multiple Buildings 1-2 Floors High Rise less than 6 floors High Rise More than 6 Floors If Condo or Townhouse, how many units are in Building? List Building 1 - Number of units / Sq ft List Building 2 - Number of units / Sq Ft List Building 3 - number of Units / Sq Ft List Building 4 - Number of Units / Sq Ft If More Than 4 building call 800 604 7249   What is the value of your personal property? Commercial Building Value of Building Construction JM Frame Stucco Block Wood Frame Fire Res Number of Stories: 1 1.5 2 Tri-level 4 - 6 6 - 10 Over 10 Square Footage Garage or Gas Station None Gas Gas and C Store Gas and Repair Roof Type: Asphalt Tile Wood Shake Year Built     Air Conditioned? Yes No Fireplace or Wood Burning Yes No Explain how building is being used, Retail, Wholesale, Storage, Bar,   Comments PLEASE NOTE WE MAY CONTACT YOU AND REQUEST ADDITIONAL INFORMATION