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New Location Application

New Location ApplicationKim Zem2022-11-11T14:37:42-08:00

New Location Application

Found a new place? Whoohoo! Let’s get it insured so you can move on and move in!

"*" indicates required fields

Step 1 of 4

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The Business Name (not the Formal Entity Name)
Your Name*
Did you change your Business Name or your Formal Entity?*
New Formal Entity?
(Full legal business name. Example Tattoo the Zoo, LLC)
Email*
Where you can receive sensitive information
Please confirm your main services*
OLD Location Address on file*
NEW Location Address*
you do NOT NEED to change a Physical Address UNLESS you have a Leased Commerical Space, Booth Rental Agreement, OR Room Lease Agreement
Current Mailing Address*
This is the address where you would like to receive mail.
What is your current Business Location(s) Situation?*
Primary Services*
Check all that apply
Estimate revenue to the end of the policy term. ONLY the ACTUAL cost of the Service. Do not include revenue from merch, jewelry, rent, or another source.
Offer any Additional Services?*
Please select all services you currently offer or are considering in the future.
Revenue in the next 12 months. ONLY the ACTUAL cost of the Service. Do not include revenue from merch, jewelry, rent, or another source.
Do you sell Retail, Merch, Supplies?*
Starting to offer Training or Instruction?
Types of Training or Instruction*

Business Property / Contents

Do you want coverage for contents at your NEW Business Location?
Decor, Art, Furniture, Antiques, Reference Material, Merchandise, and Retail Stock In the case of Fire, Vandalism, Theft?
I understand and agree that I when I select "Liability Only" it is General and Professional Liability for my services, and NOT replacement coverage for my business contents, supplies, machines, income, papers and records etc.*
Do you own the building? Do you need coverage for it?*
Making "Tenant Improvements"?*
This includes the floors, lighting, molding, cabinetry, etc. Literally how you improved the space when you moved in, to make it “Yours”. If there is a fire, we want to put it back the way it was…
To Date, what is the cost of the Improvements YOU have made to your space? We want to put it back the way it was after a loss such as fire, smoke damage etc.
Do you need Tenant Glass Coverage?
If you are responsible for the glass breakage or damage, select yes. Glass is not automatically covered; it must be added.
How much money would you need to replace your Furniture, Art, Computers, iPads, supplies, stock, merch, appliances, etc? It’s okay to overestimate here.
How much income would you need, EACH month for 3 months if your workspace was physically damaged and you could not work/generate an income?
Do you want Coverage for Equipment and Supplies taken "off site"?*
Conventions, Education, Guest Spotting, etc.
Security features. (Check all that apply)*
Theft coverage may be included, but it is subject to a working central alarm system that’s operational, notifies the 1st Responders and active at the time of loss.
Is your location (building) older than 25 Years?*
NOTE – Special Form coverage may not be available if your property manager has not performed updates and inspections.
Within 5 miles of a coastline or large body of water?*
NOTE! Wind and Storm Coverage may be Excluded for the Eastern Side of the States. Please apply for flood program coverage to cover your business operations and property!
Has there been any updates or inspections to the roof, HVAC, plumbing, or electrical?*
Please enter the Approx Year each was Updated OR Inspected below. Please ask the Property Manager or Landlord if you aren’t sure, this information is Critical for Property Coverage.
Approximate Year
Approximate Year
Approximate Year
Approximate Year

Added Coverage Options

Add Sexual Abuse Misconduct Coverage for $200 per year?*
$200,000 Sub Limit
Add Assault and Battery Coverage for $200 per year?*
$100,000 Per Claim $200,000 Aggregate Limit
Add Communicable Disease Coverage for $150 per year?*
$100,000 Sub Limit
Add Cyber Liability / Data Breach Coverage for $50 per year?*
$25,000 Sub Limit
Raise the Professional Liability Limit to 1M for $350 per year?*
$1,000,000 Professional Liability Limit (from the included $500,000)
Do you want Terrorism coverage for a Minimum of $150 per year?*
Only certified acts are eligible for coverage through TRIA. A certified terrorism event is classified by the Secretary of the Treasury, Secretary of State, or the Attorney General.
Does staff use their own cars for bank / supply / food runs?*
Do you want coverage in case they have an accident in their vehicle?*
Business owners are responsible for damages if a crew member gets in an accident while running errands.
Anything you want us to know for your renewal offer;
Let’s make sure the policy meets the requirements.
Drop files here or
Accepted file types: jpg, gif, png, pdf, Max. file size: 10 MB.
    The above information is accurate, true to my knowledge.*
    I affirm and certify that all the information and answers to questions herein are complete, true, and correct to the best of my knowledge and belief. I understand that any misrepresentation, falsification, or omission of any facts called for in the application may render this application void and will be cause for cancellation, whenever discovered.
    Consent*
    Like most insurance agencies, we use use information from you and other sources, such as your driving and claims histories, insurance score, and other factors to calculate an accurate rate for your insurance, set you up for monthly payments (if chosen). New or updated information may be used to calculate your renewal premium.
    This field is for validation purposes and should be left unchanged.
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