Calendar/Events
Testimonials
Industry Links
Careers
Contact Us
Employee Login
Nonprofit
Personal Lines
Surety Bonds
Trucking
Risk Management
Directors & Officers (D&O)
Premiere Homeowners
Commerical Business
General Liability
Professional Liability
Fiduciary Liability Insurance
Employment Practices
Crime Insurance
Property
Commercial Auto Insurance
Business Owners
Workers Compensation
Excess Liability
Individual Life & Health
Employee Benefits
Homeowner's Insurance
Auto Insurance
Trucking Insurance
Surety Bond
Small Business Form
Insurance Companies
Industry Links
Beehive Insurance Agency, Inc.
Small Business Quote Form
Business Name
Contact First Name
Contact Last Name
Contact Phone
-
-
Contact E-mail
Description of Business
Location 1
Physical Address
City
State
--
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Zip Code
Estimated Annual Sales
Store Closing Time
Building Made of
(Example: frame or block construction)
Square Footage
(of just your store)
Number of Stories
(of the building)
Year Building Built
Fire Sprinklers
Yes
No
If the building is 30 yrs old or older, please fill in the year that each of the following were updated:
Heating
Plumbing
Electrical
Roof
Business Personal Property
$
(aka contents)
Building Coverage:
If you own the building then answer this question:
Building Coverage
$
If you are leasing the building then answer these two questions:
Tenant Improvements and Betterments
$
(aka build out)
Landlord
If you are a contractor, how much work is subbed out?
%
Location 2
Physical Address
City
State
--
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Zip Code
Annual Sales
Store Closing Time
Building Made of
Square Footage
Number of Stories
Year Building Built
Fire Sprinklers
Yes
No
Building Updates:
HVAC
Plumbing
Electrical
Roof
Years in Business
Years Experience
Current Insurance
Expiration Date
Claims
Building Own / Rent
Own
Rent
Building Coverage
$
B.P. Property
$
TIB Coverage
$
Ded
$
Landlord
Location 3
Physical Address
City
State
--
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Zip Code
Annual Sales
Store Closing Time
Building Made of
Square Footage
Number of Stories
Year Building Built
Fire Sprinklers
Yes
No
Building Updates:
HVAC
Plumbing
Electrical
Roof
Years in Business
Years Experience
Current Insurance
Expiration Date
Claims
Building Own / Rent
Own
Rent
Building Coverage
$
B.P. Property
$
TIB Coverage
$
Ded
$
Landlord
Location 4
Physical Address
City
State
--
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Zip Code
Annual Sales
Store Closing Time
Building Made of
Square Footage
Number of Stories
Year Building Built
Fire Sprinklers
Yes
No
Building Updates:
HVAC
Plumbing
Electrical
Roof
Years in Business
Years Experience
Current Insurance
Expiration Date
Claims
Building Own / Rent
Own
Rent
Building Coverage
$
B.P. Property
$
TIB Coverage
$
Ded
$
Landlord