AIS Commercial Quote Sheet Business Name Doing Business As: Type of Business Type of BusinessLLCAssociationNon-profitPartnershipIndividualCorporation Target / Eff Date Mailing Address City State Zip / Postal Code Is your location address same as your mailing address? Is your location address same as your mailing address? Yes No Location Address State Zip / Postal Code City Years in business / Year your business started Business Website Location Ownership Location OwnershipOwnedRented EIN Business Phone Number Contact Last Name Contact First Name Contact Email Address Contact Phone Number Description of operations Coverage Needed Coverage Needed General Liability Property Tools/Equipment Auto Workers Comp Umbrella General Liability Section General Liability Section Annual Gross Sales / Revenue Projections for next 12 months Number of Employees Number of Full Time Number of Part Time 1099 Square Footage You Occupy Number of Active Owners Are you a contractor? Are you a contractor? Yes No Operations Payroll Clerical Payroll Subcontracting Costs Subcontracting Costs Yes No Annual Subcontracting Cost Please describe the work that is Subcontracted Property Section Property Section Year Built Number of Stories Construction Type Construction TypeFrameJoisted MasonryNon-CombustibleMetalOther Roof Type Roof TypeFlat Tile/GravelFlat FoamMetalTileAsphalt ShinglesOther Total Building Square Footage Square Footage You Occupy Sprinklers SprinklersFullyPartialNone Alarm AlarmCentalMonitoredNone Cameras / Motion Sensors Cameras / Motion SensorsCamerasMotion SensorsBothNone Please note: Any buildings over 25 years old, we will request updates on: Roof/Electrical/HVAC/Plumbing Business Personal Property Limit Business Personal Property Limit Owned Tenant Building Limit of Coverage Improvements and Betterment Limit of Coverage Inland Marine Section Inland Marine Section Total amount of tools/equipment valued under $2,500 List tools/equipment valued over $2,500 (If more than 3 please share a spreadsheet with the following details: Year, Make, Model, Serial Number, and Current Value) Do you have rented / leased equipment? Do you have rented / leased equipment? Yes No Annual Cost of Equipment Single Highest Value of Equipment Auto Section Auto Section Total Number of Drivers List down all drivers' details including: Full name, Date of Birth, License Number and License State (if more than 3, please share a spreadsheet) Total Number of Vehicles List down all vehicles' details including: Year, Make, Model, VIN, and Cost (if more than 3, please share a spreadsheet) Do you have a vehicle maintenance program in place? Do you have a vehicle maintenance program in place? Yes No Are drivers pre-qualified prior to hiring? Are drivers pre-qualified prior to hiring? Yes No Do employees use their own vehicles to run company errands? Do employees use their own vehicles to run company errands? Yes No Workers Comp Section Workers Comp Section Choose the applicable payroll types Choose the applicable payroll types Clerical Field Sales Persons Manufacturing Others List down annual payroll mount with number of employees for each payroll type. Any excluded owners? Any excluded owners? Yes No List down the names of excluded owners along with ownership percentage and job function. Excess / Umbrella Section Excess / Umbrella Section Limit of Insurance Required Limit of Insurance Required 1 Million 2 Million 3 Million 4 Million Greater than 4 Million How did you hear about us? How did you hear about us?Word of Mouth / Direct ReferralSearch Engine: Google, Bing, Yahoo etc.Social MediaBlogAIS Small Commercial Team Referrer Submit