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Farmers Insurance
Phil Mochinski Agency
Monterey Insurance Company
Get a Commercial Price Quote
First Names of Owner/s
Last Names of Owner/s
Company Name and Type of Entity E.g. Sole Prop, Partnership, Inc.
Year Company Started
Month
Day
Year
FEIN # (If Available)
Email
Phone
Company Address and Mailing Address (If Different)
Choose the type of Industry
Apartments
Condos
HOA
Restaurant
Retail Building
Contractor
Medical Office
Bakery
Architect
Other
Type of Insurance Quote Requesting
Business Owners Policy (BOP Includes Property/Liability)
Commercial Auto
Workers Comp
Liability Only
Other
Year Built of Building and Sqft (BOP Only)
Number of Units/Apts/Buildings (Bop Only)
Has the utilities been fully updated within the last 50 years? Electrical, Plumbing, Roofing, HVAC... (Bop Only)
Yes
No
If yes above, which ones?
Are you in charge of the Parking Lot? (Bop Only)
Yes
No
How many claims have you filed in the last 5 years? If yes, please explain.
Company Annual Revenue
Total Annual Payroll and number of employees part/full time. Job titles of each employee.
Total Value of Business Property on site. E.g. Machines, Equipment, Tools Furniture...
Please upload a copy of your current Dec Page
Upload File
For Commercial Auto, please upload a copy of Drivers Lic.
Upload File
Copy of Loss Runs 5 Years (If Available)
Upload File
Targeted Annual Premium
Desired Effective Date
Please provide any further information that is relevant about the business.
SIC Codes and Brief Description of each code. (Workers Comp Only)
Request a Quote
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