POLICY RECOMMENDATIONS(Please check any you are interested in)
Hired & Non-Owned Auto
Section 1: Submission Requirements
Please Note: We must receive the documents below before a quote is issued. Thank you for your cooperation.
1) Resume (New Business Only)
2) Lease Agreement
3) Daily Safety Checklist
4) Diagram of premises
5) Safety Rules
7) Loss runs for last 5 yrs.
8) Business & Financial Plan (New Business Only)
9) Evacuation Diagram & Procedures
Section 1: COMPANY INFORMATION
How did you hear about us?
Are you an ERS or Inflatable Office customer?
Proposed Effective Date - From:
Years in business:
Experience of Owners/Principals:
If this is a new operation please provide details on owners’/principal’ prior experience (attach resume)
Do you ever process payment cards?
Estimated annual number of payment card transactions:
Create Password (this will allow you to access you application at a later time) :
Please make sure that you have completed everything to the best of your knowledge before going to the next page.