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Please fill out the questions below for
an accurate quote.
You can also call us at: Office
(619) 449-8585 -
Toll Free (877) 660-8585
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Company Information
You are requesting a California
Insurance Quote
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Business
Name |
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Contact
Name |
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Position |
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DBA |
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Type of
Business |
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Business
Entity |
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Business
Address |
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City |
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Zip
Code |
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Work
Phone |
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Cell
Phone |
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E-Mail |
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Underwriting Information
(Please Explain all Yes Answers)
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Is your company a subsidiary
of another entity or
do you
have
any subsidiaries? |
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Does
your company
draw plans, designs or specifications? |
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Is there any Exposure to
flammables,
explosives, or
chemicals? |
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Does
your company
lease equipment with or without operators? |
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Does
your company currently
have General
Liability
coverage? |
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Does
your company
hold a General Contractors or Builders License? |
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Does
your company
ever do any
exterior work on buildings over
3 stories? |
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Does
your company
ever act in the capacity of a General contractor or Builder? |
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Does
your company
perform
work on boats/ships or engage
in
boating or shipping
operations? |
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Does
your company
sell products or manufacture "under your name"? |
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Does
your company
sponsor
sporting or social events? |
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Does
your company
ever do asbestos removal? |
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Has
your company
had any policy
or coverage declined, cancelled or
non-renewed? |
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Has
your company ever been named in a lawsuit
alleging construction defects? |
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Is
your company
involved
in new
residential construction and/or
development?
(present or future)
(This would include dwellings, condo
units or townhouses
located in a
single development) |
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Has
your company ever had any construction
defects, product liability or other claims? (Last
5 Years) |
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Do
you anticipate
Gross Receipts
exceed $1,000,000.? |
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Your
Anticipated Gross Receipts? |
$ |
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Do
you anticipate
Annual Payroll
exceed $300,000.? |
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Your
Anticipated Annual Payroll? |
$ |
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Are subcontractors used?
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If
yes, what is the annual cost of subcontractors?
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$ |
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Please Explain any "Yes" to any
Underwriting Information
Answers |
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List the last 3 jobs including the cost of
those jobs. |
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| Location |
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Job Receipts |
$ |
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Describe the Job |
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| Location |
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Job Receipts |
$ |
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Describe the Job |
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| Location |
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Job Receipts |
$ |
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Describe the Job |
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Years in Business ? |
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Total # of Full
Time Employees? |
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Do not Include yourself |
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Years Experience ? |
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Total # of Part
Time Employees? |
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Percent of work Preformed
(Must Equal 100%) |
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Percent of work Preformed
(Must Equal 100%) |
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% Commercial |
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% New Construction
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% Residential |
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% Remodel / Repair |
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Please Describe Your Daily Business Operations
(What does your company do?) |
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Please be detailed
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Do you have a
Contractors license |
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If yes, what is your
Contractor Number
(If you do not have a contractors license please write None) |
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Present Business Insurance Co. |
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Policy Expires
(Month / Date) |
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Liability Limits
(Coverage Desired) |
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Do you need Property Coverage |
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Claims or Losses for the last 5 years |
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Do you need Coverage for
Tool |
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Please detail All Claims or Losses for the last 5
years |
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Can
I offer you a Auto Insurance Quote? |
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Policy Expires
(Month / Date) |
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Can
I offer a Life Insurance Quote? |
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Policy Type
Term, perm |
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How
did you find our us?
(friend, web, search) |
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Comments / Request
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Submission of this
application in no way constitutes a receipt of a quotation
or approval for binding, All requirements
must be received in our office. a rate will be based on
information provided on this application and is subject to
change. |
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By clicking the
Submit button I have Reviewed the
Privacy Statement
and the
Insurance Disclosure
Statement and Understand
that
this is only a quote for the State of California, any
information and does not constitute a binder of coverage or
proof of Insurance in
any form, or does it guarantee
insurance. All Coverage's are subject to the terms and
conditions contained in the policy
and endorsements. I agree
the above information is true and factual. Insurance will
not begin until I sign a contract and make a down
payment.
Please Read
Auto
Insurance Disclosure Statement below
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This is not a binder or proof of Insurance. |
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Business
Insurance Disclosure Statement
Please Read Below
Thank you for the opportunity to discuss your Business insurance needs.
I look
Forward to
offering you the service and value that is
the standard of Ronn Hall Insurance. I am sure
you will see
hat this quote can affordable enhance your insurance program.
Please Note:
An Insured which refuses to Provide coverage to an applicant who is
a
“Good Driver” Must provide the applicant with a written
statement of the reasons it denied
coverage. In general, under
California law a “good driver” is a person who, during the last
three years, Has been continually licensed and has not had more than
one violation point or
more than One at-fault
accident resulting in only property damage.
As part of the
application process, Our Insurance Companies may collect personal information
from
Persons other than you or other individuals proposed for
coverage, including credit reports,
loss information reports,
CLUE,
and motor vehicle reports.
This information, as well as other personal
or privileged
information subsequently collected by us, may in certain circumstances be
disclosed to third parties without your authorization.
You have a right of access and correction
with respect
to al personal information we collect. If you would like more detailed
information
in writing about our information collection
practices, please let us know
All coverage’s are subject to the Terms and conditions
contained in the policy and
endorsements.
The Business Auto premiums shown are for a 12-month policy period.
If you have any questions please call me at the
Telephone number listed below.
Ronn Hall Insurance & Notary Services
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All material on this site is
intended for educational purposes only. Any proposals are not
contracts
or binders, No coverage will be afforded until an application is
completed, signed, underwritten, and
monies are exchanged. All Coverage's are subject to the terms and
conditions contained in the policy
and endorsements. If you have any questions Please call us @ (619)
449-8585
The publishers are not responsible or liable for misinformation,
misprints, or typographical errors.
All information provided is deemed reliable
but is not guaranteed and should be independently
verified. We are not responsible
for advertisers listed on this site, please research your data prior to
making a purchase.
Some links are
"Paid Ads" and will transfer you to various web sites, others are
links
including Virginia Hall Coldwell Banker, Santee Real
Estate , Mortgage companies, insurance
companies, Sporting sites, San Diego County,
government sites,
including School
Districts, and other web
sites.
All information provided is deemed reliable
but is not guaranteed and should be independently
verified. We are not responsible
for advertisers listed on this site, please research your data prior to
making a purchase
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