SIG INSURANCE SERVICES
QUOTES
Business Insurance Quote
* Mandatory Fields must be completed or otherwise the form will not process
Name
Address:
City: (* mandatory)
Province: (* mandatory)
Postal Code:
Phone Number:
Email Address (* mandatory):
Construction of building:
Frame
Masonry
Non-Combustible
Fire Resistive
Age of building:
<1 year
1 - 20 years
20 - 35 years
>35 years
Is the building sprinklered?
Yes
No
How much area do you occupy?
< 5 000
5 000 - 10 000
> 10 000
Are you the only tenant?
Yes
No
Is there a hydrant within 500 ft. (150 metres)?
Yes
No
Is there a fire hall within 3 miles (5 kms)?
Yes
No
Has insurance ever been denied or canceled?
Yes
No
What type of business?
Retail
Office
Building ownership
Wholesale operation
Farm
Service Operation
Contractor
Garage operation
Manufacturer
Other
How many years in the business?
< 1 years
1 - 5 years
> 5 years
Have there been any insurance claims in the last 3 years?
Yes
No
What are the annual receipts?
Up to $50 000
$51 000 to $100 000
$101 000 to $500 000
$501 000 to $1 000 000
Over $1 000 000
What is the annual payroll?
Up to $50 000
$51 000 to $100 000
$101 000 to $500 000
$501 000 to $1 000 000
Over $1 000 000
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