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Farmers Insurance
Phil Mochinski Agency
Monterey Insurance Company
Get a Price Quote
First Names of Owner/s
Last Names of Owner/s
Company Name and Type of Entity E.g. Sole Prop, Partnership, Inc.
Email
Phone
Address
Choose the type of Industry
Apartments
Condos
HOA
Restaurant
Retail Building
Contractor
Medical Office
Commercial Auto
Workers Comp
Bakery
Other
Year Built of Building and Sqft
Number of Units/Apts/Buildings
Has the utilities been fully updated within the last 50 years? Electrical, Plumbing, Roofing, HVAC...
Yes
No
If yes above, which ones?
Are you in charge of the Parking Lot?
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 Furniture...
Please upload a copy of the current Dec Page
Upload File
For Commercial Auto, please upload a copy of Drivers Lic.
Upload File
Copy of Loss Runs 5 Years
Upload File
Targeted Annual Premium
Desired Effective Date
Please provide any further information that is relevant about the business.
Request a Quote
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