R.L Evans Company, Inc.

Business Owners Policy

Get FREE Quotes and Information
* required information

Name:*

 

Email:*

 

Phone:

 

Year business started:*

 

How many years of experience does the owner of your business have in your industry?*

 

# of business vehicles:

 

Is your business for Profit or non-profit?

 

What is your business legal entity?

 

What industry is your company in?

 

Detailed description of the nature of business:*

 

Are you currently insured?

Yes No 

If yes, what company?

 

Expiration Date:

If currently insured, what is
your annual premium range?

$500 - 999
$1,000 - 2,999
$3,000 - 4,999
$5,000 - 9,999
 

$10,000 - 19,999
$20,000 - 49,999
$50,000+
 

Do you own or lease your office space?

Lease Own  

What type of property is your building?

Office  Retail   Industrial
Other: 
 

Total square footage of your building:*

 

Total square footage of your space:*

 

Approximate year your building constructed:*

 

Which of the following features does your building have?
(check all that apply)

Sprinkler system
Smoke detectors
Burglary alarm
Security guard
Fire alarm
 

Exterior lighting
Barred windows
Circuit breakers
Fuses
None
 

Approximate amount of liability
coverage needed:

$1,000,000
$2,000,000
$3,000,000
$4,000,000
$5,000,000+
 

What is the deductible you would like for your property coverage?

$250
$500
$1,000  

$2,500
$5,000 

# of Active Owners and/or Partners:*

 

# of Full Time Employees:*

 

# of Part Time Employees:*

 

# of Sub-Contractors:*

 

When do you need coverage to start: *

 

Other information your agent should know:

 

 

For Insurance Purposes:
This communication is strictly intended for individuals and businesses residing in the state of Washington.

 

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Plaza 600 Building : 600 Stewart Street : Suite 1210 : Seattle, WA 98101
Telephone 206.448.7878 : Facsimile 206.448.3589
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