arclight1stg, Author at ArcLight Insurance

General Liability Quote

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This field is for validation purposes and should be left unchanged.

Applicant Information

Applicant Entity Type:(Required)

Individual

Partnership

Corporation

LLC

Joint Venture

Other

Applicant Name:(Required)

Applicant's Company Name:(Required)

(N/A if you don't have one)

Applicant's Full Name:(Required)

First Last

Applicant's Company Name:(Required)

(N/A if you don't have one)

Owner's Full Name:(Required)

First Last

Business Address:(Required)

Street Address Address Line 2 City State ZIP Code

Is business address same as mailing address?(Required)

Yes

Mailing Address:(Required)

Street Address Address Line 2 City State ZIP Code

Phone:(Required)

Fax:

Email:(Required)

Website(Required)

FEIN (Tax ID #):(Required)

Does the applicant have a DBA (Doing Business As) name:

In what year did the applicant start operations?(Required)

Please describe the applicant's day-to-day business operations: (Please be detailed)(Required)

Are there any locations or business interests that are owned by the applicant but not shown on the application?(Required)

Yes

If so, list locations/interests:(Required)

Are there high-valued goods, including merchandise at your location?(Required)

Yes

If yes, what is the approximate value of your inventory?(Required)

What is the value of your business personal property?(Required)

(BPP are all your furniture, computers, printers, etc. — basically, anything you will take with you if you move.)

Business Operations & Exposure Information

Do you operate at a fixed location, client sites, or both?(Required)

Fixed Location

Client Sites

Both

Do customers visit your business location?(Required)

If customers are allowed on-site on business premises, answer Yes.

Yes

Do you sell, manufacture, or distribute products?(Required)

Yes

If yes, please describe:(Required)

Do you require vendors, contractors, or subcontractors to carry their own liability insurance?(Required)

Yes

Do you use company-owned, leased, or employee-owned vehicles for business operations?(Required)

Yes

Do you engage in any high-risk activities (e.g., hazardous material handling, heavy equipment operations, security services, construction work)?(Required)

Yes

If yes, please describe:(Required)

Do you enter contracts requiring general liability coverage?(Required)

Yes

If yes, please provide details:(Required)

Coverage & Limits Requested

Requested Coverage Limits:(Required)

$1 Million Per Occurrence / $2 Million Aggregate

$2 Million Per Occurrence / $4 Million Aggregate

Other (please specify):

Other (please specify):(Required)

Requested Deductible Amount:(Required)

$500

$1,000

$2,500

Other:

Other:(Required)

Do you need additional coverage for the following? (Check all that apply)(Required)

Products & Completed Operations Liability

Liquor Liability

Cyber Liability

Hired & Non-Owned Auto Coverage

Employee Benefits Liability

Additional Insureds

Additional Insureds (please specify):(Required)

Risk Management & Safety Measures

Do you have a written safety program?(Required)

Yes

Do you provide employee safety training?(Required)

Yes

Do you conduct background checks on employees?(Required)

Yes

Do you have security measures in place at your business locations?(Required)

Yes

If yes, please describe:(Required)

Insurance History & Claims Information

Do you currently have general liability insurance?(Required)

Yes

If yes, name of current insurer:(Required)

Policy expiration date:(Required)

MM slash DD slash YYYY

Current coverage limit:(Required)

Have you had any liability claims in the past five years?(Required)

Yes

If yes, please provide details (date, type of claim, amount paid):(Required)

Has the applicant ever had insurance coverage canceled or non-renewed?(Required)

Yes

If yes, please explain:(Required)

Additional Comments or Special Considerations

(Please provide any other relevant information that may impact your insurance coverage needs.)

by arclight1stg

Builders Risk Quote

Company

This field is for validation purposes and should be left unchanged.

Applicant Information

Applicant Entity Type:(Required)

Individual

Partnership

Corporation

LLC

Joint Venture

Trust

Other

Applicant Name:(Required)

Applicant's Full Name(Required)

First Last

Applicant's Company Name:(Required)

(N/A if you don't have one)

Owner's Full Name(Required)

First Last

Construction Address:(Required)

Street Address Address Line 2 City State ZIP Code

Business Address:(Required)

Street Address Address Line 2 City State ZIP Code

Construction Address:(Required)

Street Address Address Line 2 City State ZIP Code

Is business address same as mailing address?(Required)

Yes

Is construction address same as mailing address?(Required)

Yes

Mailing Address:(Required)

Street Address Address Line 2 City State ZIP Code

Phone Number(Required)

Fax

Email Address(Required)

Website

FEIN (Tax ID #):(Required)

Does the applicant have a DBA (Doing Business As) name:

In what year did the applicant start operations?(Required)

Please describe the applicant's day-to-day business operations:(Required)

Main area of practice, type of services provided, products, etc. - Please be detailed

Are there any locations or business interests that are owned by the applicant but not shown on the application?(Required)

Yes

Are there high-valued goods, including merchandise at your location?(Required)

Yes

If yes, what is the approximate value of your inventory?(Required)

What is the value of your business personal property?(Required)

(BPP are all your furniture, computers, printers, etc. Basically, anything you will take with you if you move)

Annual Gross Revenue:(Required)

Annual Gross Income:(Required)

Contractor License:(Required)

State(s) / Area of Operation:(Required)

Licensed for Business in State(s):(Required)

Is applicant or any proposed named insured one of the following? (Check all that apply)(Required)

Construction Consultant

Construction Manager

Developer

General Contractor

Subcontractor

Spec Builder

Architect/Engineer

Surveyor

Does the applicant currently own or operate any other business?(Required)

Yes

If yes, list name and describe operations and percentage of ownership:(Required)

Construction Information

Project Name

Type of Construction(Required)

New Construction

Renovation

Remodel

Addition

Type of Building(Required)

Residential

Commercial

Industrial

Mixed-Use

Number of Stories:(Required)

Please enter a number from 1 to 99.

Total Square Footage:(Required)

Please enter a number from 0 to 99999.

Estimated Project Value:(Required)

Please enter a number from 0 to 9999999.

Project Start Date:(Required)

MM slash DD slash YYYY

Expected Completion Date:(Required)

MM slash DD slash YYYY

Who Owns the Property?(Required)

Owner

Contractor

Developer

Other

Who is the General Contractor?(Required)

Name

License Number

Experience (Years)

Contact Info

Will any subcontractors be used?(Required)

Yes

If yes, are they required to carry insurance?(Required)

Yes

Is this a ground-up construction project?(Required)

Yes

If no, describe existing structure and modifications being made:(Required)

Will the building be occupied during construction?(Required)

Yes

Do you have all necessary permits for this project(Required)

Yes

Requested Coverage Details

Requested Coverage Limits

Building / Structure:(Required)

Please enter a number from 0 to 9999999.

Soft Costs:(Required)

Please enter a number from 0 to 999999.

Debris Removal:(Required)

Please enter a number from 0 to 999999.

Temporary Structures:(Required)

Please enter a number from 0 to 999999.

Equipment & Tools:(Required)

Please enter a number from 0 to 999999.

Requested Deductible Amount:(Required)

$1,000

$2,000

$5,000

Other

Do you require coverage for:(Required)

Materials in transit?

Materials stored off-site?

Soft costs (e.g., permits, fees, legal expenses)?

Equipment breakdown?

Flood or earthquake damage?

Theft or vandalism?

Do you employ temporary, volunteer, casual workers or uninsured subcontractors?(Required)

Yes

If yes, please describe:(Required)

Will subcontractors be required to carry their own insurance?(Required)

Yes

Will there be any hazardous activities on-site? (e.g., blasting, demolition, excavation)(Required)

Yes

If yes, please describe:(Required)

Who should be listed as additional insureds?(Required)

Risk Management & Safety Measures

Does your safety program contain the following written procedures? Please check all that apply:(Required)

Safety rules & regulations

Safety meetings

Site safety inspections

Fall protection requirements

Substance abuse prevention

Accident investigation / reporting

Fall protection requirements

Fire / Protection training

Hazardous material handling

No Safety Procedures Enforced

Unsure

Does the applicant have a formal safety program in place?(Required)

Yes

Do you require workers to wear personal protective equipment (PPE)?(Required)

Yes

Does the applicant offer an orientation/training program for new or transferred employees?(Required)

Yes

What security measures will be in place at the construction site?(Required)

Fencing

Surveillance Cameras

Security Guards

Locked Storage for Materials

Other

Please list other:(Required)

What weather protection measures will be in place?(Required)

Storm Covers

Drainage Systems

Flood Barriers

Other

Please describe other:(Required)

Insurance History & Claims Information

Do you currently have builder’s risk insurance?(Required)

Yes

If yes, name of current insurer:(Required)

Policy expiration date(Required)

MM slash DD slash YYYY

Current coverage limit:(Required)

Please enter a number from 0 to 999999.

Have you had any builder’s risk claims in the past five years?(Required)

Yes

If yes, please provide details (date, type of claim, amount paid):(Required)

Has the applicant ever had insurance coverage canceled or non-renewed?(Required)

Yes

If yes, please explain:(Required)

Additional Comments or Special Considerations

(Please provide any other relevant information that may impact your insurance coverage needs.)

by arclight1stg

Equipment Floater Quote

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This field is for validation purposes and should be left unchanged.

Applicant Information

Applicant Entity Type:(Required)

Individual

Partnership

Corporation

LLC

Joint Venture

Other

Applicant Name:(Required)

Applicant's Name:(Required)

First Last

Applicant's Company Name:(Required)

(N/A if you don't have one)

Owner's Name:(Required)

First Last

Business Address:(Required)

Street Address Address Line 2 City State ZIP Code

Is the business address the same as the mailing address?(Required)

Yes

Mailing Address:(Required)

Street Address Address Line 2 City State ZIP Code

Phone:(Required)

Fax:

Email:(Required)

Website

FEIN (Tax ID #):(Required)

Does the applicant have a DBA (Doing Business As) name:(Required)

In what year did the applicant start operations?(Required)

Please describe the applicant's day-to-day business operations:(Required)

Main area of practice, type of services provided, products, etc. - Please be detailed

Are there any locations or business interests that are owned by the applicant but not shown on the application?(Required)

Yes

If so, please list:(Required)

Are there high-valued goods, including merchandise at your location?(Required)

Yes

If yes, what is the approximate value of your inventory?(Required)

What is the value of your business personal property? (BPP are all your furniture, computers, printers, etc. Basically, anything you will take with you if you move)(Required)

Annual Gross Revenue:(Required)

Contractor License:(Required)

State(s) / Area of Operation:(Required)

Licensed for Business in State(s):(Required)

Equipment Coverage Information

Type of Equipment to be Insured: (Check all that apply)(Required)

Heavy Construction Equipment (e.g., bulldozers, excavators, cranes)

Contractor’s Tools & Machinery

Agricultural Equipment

Medical or Diagnostic Equipment

Photography or Film Equipment

Mobile Equipment (e.g., food trucks, generators)

IT & Electronic Equipment (e.g. servers, laptops, etc.)

Other (please specify):

Other (please specify):(Required)

What is the total estimated value of the equipment to be insured?(Required)

Do you own or lease the equipment?(Required)

Own

Lease

Is there a loss payee for any of the equipment?(Required)

Hint: This would apply if equipment was purchased with a loan that has yet to be paid off.

Yes

Loss Payee Info:(Required)

Please list all loss payees

Lender Name

Address

Phone #

Equipment

Is the equipment new or used?(Required)

New

Used

Does the applicant transport equipment between job sites?(Required)

Yes

Do you have GPS tracking or anti-theft devices on your equipment?(Required)

Yes

Is the equipment stored at a secured location when not in use?(Required)

Yes

If yes, please describe storage conditions (e.g., fenced yard, locked warehouse, surveillance cameras):(Required)

Do you have an existing maintenance program for your equipment?(Required)

Yes

Do employees take equipment off-site?(Required)

Yes

Equipment Schedule

Please list all equipment to be covered under this policy.

Equipment(Required)

Name/Description

Year

Make/Model

Serial Number

Value ($)

Owned/Leased

Coverage & Claims Information

Requested Coverage Limit:(Required)

$50,000

$100,000

$250,000

Other:

Please specify other:(Required)

Requested Deductible Amount:(Required)

$500

$1,000

$2,500

Other:

Other:(Required)

Do you currently have equipment floater insurance?(Required)

Yes

If yes, name of current insurer:(Required)

Policy expiration date:(Required)

MM slash DD slash YYYY

Current coverage limit:(Required)

Claims & Loss History

Have you had any equipment-related claims in the past five years?(Required)

Yes

If yes, provide details including date, amount paid, and type of claim:(Required)

Have you had any stolen, damaged, or lost equipment incidents?(Required)

Yes

If yes, provide details:(Required)

Has any insurer canceled, denied, or declined to renew coverage in the past five years?(Required)

Yes

If yes, please provide details:(Required)

Additional Coverage Options

Would you like to include coverage for the following? (Check all that apply)

Rental Equipment Coverage

Employee-Owned Tools & Equipment Coverage

Business Interruption Due to Equipment Breakdown

Flood or Earthquake Damage Coverage

Transit Coverage (for equipment being transported)

Additional Comments or Special Considerations

(Please provide any other relevant information that may impact your insurance coverage needs.)

by arclight1stg

Garage & Dealers Quote

Name

This field is for validation purposes and should be left unchanged.

Applicant Information

Applicant Entity Type:(Required)

Individual

Partnership

Corporation

LLC

Joint Venture

Other

Applicant Name:(Required)

Applicant's Name(Required)

First Last

Applicant's Company Name:(Required)

(N/A if you don't have one)

Owner's Name(Required)

First Last

Owner's DOB:(Required)

MM slash DD slash YYYY

Owner's Position(Required)

Applicant's DOB:(Required)

MM slash DD slash YYYY

Applicant's Position(Required)

What is the applicant's corporate name?(Required)

(This is the name that goes on the tax returns)

Business Address(Required)

Street Address Address Line 2 City State ZIP Code

Is business address different than mailing address?(Required)

Yes

Mailing Address(Required)

Street Address Address Line 2 City State ZIP Code

Contact Person:(Required)

Phone:(Required)

Fax:

Email:(Required)

Web Address:

FEIN (Tax ID #):(Required)

Does the applicant have a DBA (Doing Business As) name?

Do you operate at multiple locations?(Required)

Yes

If yes, list all locations:(Required)

In what year did the applicant start operations?(Required)

Is this entity a franchise?(Required)

Applicant pays for the right to operate under the franchisor's brand and system, the franchisor being the one that owns the brand, products, and business model

Yes

Describe what type of service(s) you provide (please describe in detail):(Required)

Are there any locations or business interests that are owned by the applicant but not shown on the application?(Required)

Yes

If yes, please describe in detail:(Required)

Industry Type

Select all that apply:(Required)

New Auto Sales

Used Auto Sales

Auto Repair/Service

Tire Sales & Service

Towing Service

Parking Garage/Valet

Body Shop/Collision Repair

Other

Other (please specify):(Required)

Business Operations & Coverage Needs

Do you have a dealer's license?(Required)

Yes

Dealer's License Number:(Required)

License expiration date:(Required)

MM slash DD slash YYYY

Dealer's License Photo Upload (optional):

Max. file size: 50 MB.

Do you perform vehicle repairs or maintenance?(Required)

Yes

Do you offer towing services?(Required)

Yes

Do you sell used or new vehicles?(Required)

New

Used

Both

Do you offer rental or loaner vehicles?(Required)

Yes

Do you conduct repossessions?(Required)

Yes

Do you conduct vehicle storage?(Required)

Yes

Do you provide mobile repair services?(Required)

Yes

Do you provide pick-up/delivery of customer vehicles?(Required)

Yes

Do you own, lease, or rent the business premises?(Required)

Own

Lease

Rent

Are you involved in importing autos?(Required)

Yes

Are you involved in public or livery passenger conveyance or on-demand delivery/courier services?(Required)

Yes

Are you involved in any racing, race car preparations/repair, or race sponsorship?(Required)

Yes

If yes, please describe:(Required)

Do you have any hazardous exposures in your operations?(Required)

Yes

If so, please describe hazard exposures in detail:(Required)

Are jacks and car lifts stored in a protected area after work hours?(Required)

Yes

Garage & Property Details

Number of locations:(Required)

Garaging address(es) of locations:(Required)

Total square footage of garage/lot:(Required)

Lot security measures:(Required)

(Check all that apply)

Fenced lot

Security cameras

Alarm system

Security guards

Other

Other (please specify):(Required)

Estimated number of customer vehicles on premises daily:(Required)

Estimated value of all customer vehicles on premises at any time:(Required)

Does the facility have a fire suppression system?(Required)

Yes

On average, how many customer vehicles are in your care, custody, or control at any given time?(Required)

Please enter a number greater than or equal to 0.

What is the maximum number of customer vehicles in your care?(Required)

Please enter a number greater than or equal to 0.

What is the estimated average value of a single customer in your care?(Required)

Please enter a number greater than or equal to 0.

What is the maximum value of any single vehicle you handle?(Required)

Please enter a number greater than or equal to 0.

What is the aggregate total value of all customer vehicles you could have in your care, custody, or control at any one time?(Required)

Please enter a number greater than or equal to 0.

What are the primary reasons customer vehicles are on your premises?(Required)

(e.g., repair, service, storage, parking, for sale on consignment)

What security measures are in place for customer vehicles?(Required)

(e.g., locked gates, fencing, surveillance cameras, security personnel, restricted access to keys)

Do you require customers to sign waivers or disclaimers regarding vehicle damage?(Required)

(Note: These may not hold up legally, but show intent)

Sales Operations (for Dealerships)

Are you a dealership?(Required)

Yes

What types of vehicles are sold (e.g., new, used, passenger, commercial trucks, RVs, motorcycles)?(Required)

What is the approximate average value and maximum value of a vehicle in your sales inventory?(Required)

What is the average and maximum number of vehicles in your sales inventory at any one time? (This influences the "Dealers Physical Damage" or "Inventory" limit).(Required)

What are the primary sources for acquiring used vehicles (e.g., trade-ins, auctions, wholesale)?(Required)

Do you provide any financing or extended warranty products?(Required)

Are demonstration drives offered?(Required)

Yes

What are the policies for demo drives (e.g., driver license check, accompanying salesperson)?(Required)

Do you lend vehicles to customers (loaners/service vehicles)? If so, how many, what type, and what are the customer qualifications?(Required)

Garage Keepers Coverage

Do you need Garage Keeper's Coverage?(Required)

This is coverage for customer vehicles that are in your care, custody, and/or control.

Yes

Type of Garage Keepers Coverage requested:(Required)

Legal Liability

Direct Primary

Direct Excess

Maximum number of customer vehicles on-site at any time:(Required)

Please enter a number greater than or equal to 0.

Average value per customer vehicle ($):(Required)

Please enter a number greater than or equal to 0.

Do employees drive customer vehicles?(Required)

Yes

What is the capacity of the parking facility?(Required)

Is it self-park or valet service?(Required)

What are the security measures for the parking area?(Required)

(e.g., attendants, cameras, controlled access)

What are the procedures for handling keys for valet service?(Required)

Employees & Driver Information

Total number of employees who operate vehicles:(Required)

Please enter a number greater than or equal to 0.

Do you perform MVR (Motor Vehicle Record) checks?(Required)

Yes

Do employees take customer vehicles off-site?(Required)

Yes

Do you have a written vehicle safety policy?(Required)

Yes

Are employees required to complete defensive driving courses?(Required)

Yes

Do you employ minors who drive vehicles?(Required)

Yes

Driver Information:(Required)

Full Name / Date of Birth

Driver's License #

State

FT/PT

# Accidents

Has Auto Policy?

Vehicle Information

Please provide details of all applicant-owned business vehicles:(Required)

(Attach separate document if needed)

Year, Make, Model

VIN

Garage Location

Use Type (Service, Sales, Personal, Other)

Estimated Annual Mileage

Drivers Assigned to Vehicle

A document can be uploaded if you do not wish to provide vehicle information above.

This document must contain information on each applicant-owned business vehicle, including: Year Make Model, VIN, Garaging Location, Usage Type (Service, Sales, Personal, Etc), Est Annual Mileage, Drivers Assigned to Vehicle)

I want to upload a document instead

Business Vehicle List - Document Upload:(Required)

Max. file size: 50 MB.

Insurance History & Loss Experience

Do you currently have Garage Liability insurance?(Required)

Yes

If yes, name of current insurer:(Required)

Policy expiration date:(Required)

MM slash DD slash YYYY

Current coverage limits:

Garage Liability:(Required)

Please enter a number greater than or equal to 0.

Garage Keepers:(Required)

Please enter a number greater than or equal to 0.

Other:

Please enter a number greater than or equal to 0.

Requested coverage limits:

Deductible Preference:

Please enter a number greater than or equal to 0.

Covered Autos Liability:

Please enter a number greater than or equal to 0.

Limit Each Accident

General Liability: Bodily Injury & Property Damage:

Please enter a number greater than or equal to 0.

Limit Each Accident

Damages to Premises Rented to You:

Please enter a number greater than or equal to 0.

Limit Any One Premise

Personal & Advertising Injury Liability:

Please enter a number greater than or equal to 0.

Any One Person/Organization Limit

General Liability:

Please enter a number greater than or equal to 0.

Aggregate Limit

Products and Work You Performed

Please enter a number greater than or equal to 0.

Aggregate Limit

Scheduled Autos: Coverage(s)(Required)

Liability

Specified Causes

Comprehensive

Collision

Have there been any prior Garage or Commercial Auto claims, losses, or incidents (regardless of fault or of insurance paid) in the last five years?(Required)

Yes

If yes, please provide full details including dates, descriptions, amounts paid, current status, and vehicle details if applicable:(Required)

Has any previous Garage/Dealers insurance been declined, cancelled, or non-renewed?(Required)

Yes

If yes, please explain the circumstances:(Required)

Additional Notes & Special Considerations

Additional Notes (Optional)

by arclight1stg

Workers Comp Quote

Name

This field is for validation purposes and should be left unchanged.

Applicant Information

Applicant Entity Type(Required)

Individual

Partnership

Corporation

LLC

Joint Venture

Applicant Name(Required)

Applicant's Name(Required)

First Last

Applicant's Company Name(Required)

(N/A if you don't have one)

Owner's Name(Required)

First Last

Business Address(Required)

Street Address Address Line 2 City State ZIP Code

Is business address the same as mailing address?(Required)

Yes

Mailing Address(Required)

Street Address Address Line 2 City State ZIP Code

Phone Number(Required)

Fax

Email(Required)

Website

FEIN (Tax ID #):(Required)

Does the applicant have a DBA (Doing Business As) name:

In what year did the applicant start operations?(Required)

Please describe the applicant's day-to-day business operations:(Required)

Main area of practice, type of services provided, products, etc. - Please be detailed

Are there any locations or business interests that are owned by the applicant but not shown on the application?(Required)

Yes

If Yes, please describe in detail:(Required)

Are you an existing entity seeking a new policy, or a new venture (no previous policies)?(Required)

Existing

New

If New, please describe in detail:(Required)

Does applicant own any business autos?(Required)

Yes

If Yes, please describe in detail:(Required)

Has the applicant or any principal of the business declare bankruptcy in the last seven years?(Required)

Yes

If yes, provide name, date filed, court case, case number, chapter, status:(Required)

List all physical locations where employees perform work:(Required)

Construction type:(Required)

Frame

Joisted Masonry

Non-Combustible

Modified fire resistive

Age of building:(Required)

Number of floors:(Required)

Seismically retrofitted?(Required)

Yes

Payroll(Required)

Expiring Year

1st Prior Year

2nd Prior Year

3rd Prior Year

Premium(Required)

Expiring Year

1st Prior Year

2nd Prior Year

3rd Prior Year

Are any employees working remotely or from home?(Required)

Yes

If so, describe their duties and how their work environment is managed for safety:(Required)

Do employees regularly work out of state?(Required)

Yes

If so, which states and for what purpose/duration?(Required)

What is the value of your business personal property? (BPP are all your furniture, computers, printers, etc. Basically, anything you will take with you if you move)(Required)

Employee Information

Total number of employees:(Required)

Full-time:(Required)

Part-time:(Required)

Seasonal:(Required)

Independent Contractors:(Required)

Do you use temporary or leased employees?(Required)

Yes

If yes, please provide details:(Required)

Do you provide health benefits to employees?(Required)

Yes

How many employees work at each location?

Single Location(Required)

Multiple Locations(Required)

Remote Work(Required)

Do employees travel for work purposes?(Required)

Yes

If yes, how often and for what purpose?(Required)

Payroll & Classification Information

Estimated annual payroll for all employees:(Required)

Employee job classifications and payroll breakdown:(Required)

Job Title

Number of Employees

Annual Payroll

Description of Duties

Are there any "special" employees like Executive Officers, Partners, LLC Members?(Required)

Yes

Are they to be included or excluded from coverage?(Required)

Included

Excluded

If included, what is their payroll?(Required)

Do you utilize subcontractors or independent contractors?(Required)

Yes

For each, do you obtain certificates of insurance (COIs) showing their own Workers' Compensation coverage?(Required)

Yes

What is the annual cost of subcontractors without a valid WC COI? (This payroll may be added to your policy for premium calculation).(Required)

What is the nature of the work performed by these subcontractors?(Required)

Do you have a copy of each subcontractor’s license number?(Required)

Yes

Do employees operate machinery or heavy equipment?(Required)

Yes

Do employees handle hazardous materials?(Required)

Yes

If yes, please describe:(Required)

Automobiles

Business operations include driving by employees for the following employees:

Delivery(Required)

Yes

Frequency of Delivery(Required)

Daily

Weekly

Other

Radius(Required)

Travel to or between Jobsites/Facility Location(Required)

Yes

Vehicle inspection/maintenance program(Required)

Yes

Vehicle maintenance is performed by employees(Required)

Yes

Employees take company vehicles home at night(Required)

Yes

Operations / Practices

Paid Time Off (PTO), Vacation, and Sick Time Programs:(Required)

Yes

Employee Assistance Program:(Required)

Yes

Medical / Healthcare Insurance for Employees:(Required)

Yes

Dental Insurance for Employees:(Required)

Yes

Vision Insurance for Employees:(Required)

Yes

Supplementary Disability Insurance for Employees:(Required)

Yes

Employee Retirement Plan / Pension Plan / 401k for Employees:(Required)

Yes

Check all of the hiring practices implemented by the applicant:(Required)

Written job description

Employee orientation/training

Harassment Prevention Protocols

Drug-free Workplace

Periodic Performance Reviews

Exit Interview

Check all of the following practices implemented by the applicant:(Required)

Injury and Illness Prevention Program

Outdoor Heat Control Plan

Ladder Safety Plan

Emergency Response Plan

Blood-borne Pathogens Safety Program

Respiratory Protection Plan

Confined Spaces Plan

Driver Safety Plan

Disaster Recovery Plan

Hearing Loss Prevention Plan

Fall Protection Plan

Forklift Safety Plan

Safety & Risk Management

Do you have a written workplace safety program?(Required)

Yes

Do employees receive regular safety training?(Required)

Yes

Does applicant track and document safety efforts and safety training?(Required)

Yes

Does applicant provide necessary safety (personal protective) equipment to employees and any necessary training for the equipment?(Required)

Yes

Does applicant provide safety incentives for employees who achieve compliance?(Required)

Yes

Does applicant enforce disciplinary consequences for employees who violate safety procedures?(Required)

Yes

Do you conduct background checks on new hires?(Required)

Yes

Do you conduct drug testing before or during employment?(Required)

Yes

Do you have an established return-to-work program for injured employees?(Required)

Yes

Do you have a designated safety officer or risk manager?(Required)

Yes

If yes, please provide their name and title:(Required)

Are new employees provided with safety orientation and specific job hazard training?(Required)

Yes

Is personal protective equipment (PPE) provided and enforced (e.g., hard hats, safety glasses, gloves, respirators)?(Required)

Yes

What is the process for reporting workplace hazards and near misses?(Required)

Are regular safety inspections conducted (internal or external)?(Required)

Yes, Internal

Yes, External

Yes, Both

No Inspections Conducted

What is your hiring process? Do you conduct background checks?(Required)

Are physical examinations or fitness-for-duty tests required for certain roles?(Required)

Yes

Claims History & Current Coverage

Do you currently have workers' compensation insurance?(Required)

Yes

If yes, name of current insurer:(Required)

Policy expiration date:(Required)

Current policy limits:(Required)

Please provide currently valued loss runs for the past 3-5 years for Workers' Compensation. These should include:(Required)

Policy Period Dates

Total incurred losses (Paid+Reserves)

# of Claims (Open and Closed)

Description of each claim (injury type, body part, cause, date of injury)

Status of Open Claims

Experience Modification Factor (N/A if not applicable)

Have any previous Workers' Compensation policies been declined, cancelled, or non-renewed? If yes, please explain the circumstances.(Required)

Yes

If yes, please explain the circumstances.(Required)

What measures have been implemented to prevent recurrence of past claims?(Required)

Additional Coverage & Endorsements

Would you like to include coverage for the following? (Check all that apply)(Required)

Employer’s Liability Coverage

Waiver of Subrogation

Occupational Accident Insurance

Coverage for Out-of-State Employees

Other (please specify):

Other (please specify):(Required)

Desired Effective Date:(Required)

MM slash DD slash YYYY

Requested Coverage Limits:(Required)

Requested Deductibles:(Required)

Additional Comments or Special Considerations

(Please provide any other relevant information that may impact your insurance coverage needs.)

by arclight1stg

Commercial Auto Quote

X/Twitter

This field is for validation purposes and should be left unchanged.

Applicant Information

Applicant Entity Type:(Required)

Individual

Partnership

Corporation

LLC

Joint Venture

Other

Applicant Name(Required)

Applicant's Name(Required)

First Last

Applicant's Company Name(Required)

(N/A if you don't have one)

Owner's Name(Required)

First Last

Business Address(Required)

Street Address Address Line 2 City State ZIP Code

Is business address the same as mailing address?(Required)

Yes

Mailing Address(Required)

Street Address Address Line 2 City State ZIP Code

Phone Number(Required)

Fax

Email Address(Required)

Website

FEIN (Tax ID #)(Required)

Does the applicant have a DBA (Doing Business As) name:

In what year did the applicant start operations?(Required)

Please describe the applicant's day-to-day business operations:(Required)

Main area of practice, type of services provided, products, etc. - Please be detailed

Are there any vehicles that have been customized, altered, or that have special equipment?(Required)

Yes

If yes, please describe:(Required)

Are there any vehicles leased to others?(Required)

Yes

Annual Revenue:(Required)

Total Number of Employees:(Required)

Number of Full Time Employees:(Required)

Number of Part Time Employees:(Required)

Number of Contractors:(Required)

What are your standard operating hours?(Required)

Total number of vehicles to be insured:(Required)

Do vehicles transport hazardous materials?(Required)

Yes

If yes, complete the following:

a) Does applicant have a written emergency spill plan for drivers?(Required)

Yes

b) Is applicant registered to haul hazardous materials?(Required)

Yes

c) Does applicant deliver products to rail yards, marinas, or airports?(Required)

Yes

d) Does applicant unload directly onto the trains, watercraft, or aircraft?(Required)

Yes

e) Are drivers trained to handle the hazardous materials using the proper equipment?(Required)

Yes

Are vehicles equipped with GPS tracking or telematics?(Required)

Yes

Please specify provider:(Required)

Operations

What is the typical operating radius of your vehicles from your primary business location? (e.g., local, regional, interstate):(Required)

Do vehicles cross state lines or international borders?(Required)

Yes

Which states/countries?(Required)

Are there any other business operations or services provided that are not directly related to the primary activity, especially those involving vehicle use?(Required)

Yes

Please describe other operations:(Required)

Vehicle Information

How many commercial vehicles are owned or leased by the applicant for business purposes?(Required)

Please provide details for each vehicle below:

List(Required)

Year

Make

Model

VIN

Owned or Leased?

Usage Type (Delivery, Service, etc.)

Est. Annual Mileage

Garage Location (City, State)

Are all vehicles registered under the applicant's name?(Required)

Yes

If no, please explain:(Required)

Are any vehicles equipped with specialized equipment (e.g., refrigeration units, lift gates, trailers)?(Required)

Yes

If yes, please explain:(Required)

Are vehicles regularly maintained?(Required)

Yes

If yes, how often?(Required)

Vehicle Use & Operations

What is the primary use of vehicles (e.g., service, delivery, sales, farm use, personal use by owner/employee, long-haul trucking, public livery)?(Required)

This is critical for rating. If there are multiple uses, please describe percentage of each use:

What is the Estimated Annual Mileage?(Required)

Where is/are the vehicle(s) primarily parked when not in use?(Required)

Street Address Address Line 2 City State ZIP Code

Is it a secure location (e.g., locked lot, garage)?(Required)

Is/Are the vehicle(s) owned, leased, or financed?(Required)

Owned

Leased

Financed

If financed/leased, what is the lienholder/lessor's name?(Required)

What is the leainholder/lessor's address?(Required)

Street Address Address Line 2 City State ZIP Code

What is the lien amount?(Required)

Are there any permanently attached or custom-built features (e.g., custom shelving, toolboxes, liftgates, snow plows, special bodies)?(Required)

Yes

If so, please list the feature and its value:(Required)

Permanent/Custom Feature

Value

What type of goods or materials are typically transported in this vehicle? Are they hazardous, perishable, or high-value?(Required)

Do employees or contractors use personal vehicles for business purposes?(Required)

Yes

If yes, how often and for what purposes?(Required)

Do you own any mobile equipment or operate any mobile equipment off premises?(Required)

Yes

If yes, please describe:(Required)

Driver Information

Please list all drivers:(Required)

Full Name

DOB

License #

State of Issue

License Class

Years of Exp

Motor Vehicle Record (MVR) History for Drivers:

(please provide from DMV for a good driver discount, if applicable)

Any at-fault accidents in the last 3-5 years? (Provide dates, details, and amounts if known):(Required)

Any moving violations in the last 3-5 years? (e.g., speeding, reckless driving, DUI/DWI, distracted driving):(Required)

Any suspensions or revocations of driver's license?(Required)

Is any formal defensive driving or specialized training provided to drivers?(Required)

Does the applicant have a drug and alcohol testing policy, especially for CDL drivers (DOT compliance)?(Required)

How are drivers screened and vetted prior to employment? (e.g., MVR checks, prior employment verification)(Required)

Are MVRs run periodically on existing drivers? How often?(Required)

Are drivers required to report changes in their license status or personal driving record?(Required)

Coverage & Policy Information

Requested Coverage Limits:

Liability per occurrence:(Required)

Liability aggregate:(Required)

Collision per vehicle:(Required)

Comprehensive per vehicle:(Required)

Do you require uninsured/underinsured motorist coverage?(Required)

Yes

Uninsured/Underinsured Motorist Limit:(Required)

Hired & Non-Owned Auto Coverage:(Required)

Yes

Medical Payments Coverage:(Required)

Yes

Do you need physical damage coverage for company-owned vehicles?(Required)

Yes

If yes, what is your preferred deductible?(Required)

$500

$1000

Other

Other amount:(Required)

Would you like coverage for rental vehicles or hired/non-owned vehicles?(Required)

Yes

Do you need cargo insurance for transported goods?(Required)

Yes

If yes, what is the estimated value of cargo per trip?(Required)

Would you like roadside assistance coverage?(Required)

Yes

Would you like Additional Insured / Waiver of Subrogation?(Required)

Yes

Safety & Risk Management

Do you have a written fleet safety policy?(Required)

Yes

If yes, please describe:(Required)

Are there policies regarding cell phone use, distracted driving, fatigue management, and aggressive driving?(Required)

Are drivers provided with safety equipment (e.g., reflective vests, cones, first-aid kits)?(Required)

Yes

If yes, please describe:(Required)

How often are vehicle inspections performed?(Required)

Do drivers have access to 24/7 roadside assistance?(Required)

Yes

How are vehicles maintained? (In-house mechanics, third-party repair shops, dealership service) please describe:(Required)

What is the preventative maintenance schedule for all vehicles?(Required)

Are vehicle logs kept? Are pre-trip and post-trip inspections conducted?(Required)

What procedures are in place for drivers to follow in the event of an accident?(Required)

How are accidents reported internally and to the insurer?(Required)

Insurance History & Claims Information

Do you currently have commercial auto insurance?(Required)

Yes

Name of current insurer:(Required)

Current policy limits:(Required)

Policy expiration date:(Required)

MM slash DD slash YYYY

Have there been any prior commercial auto claims, losses, or incidents (regardless of fault or if insurance paid) in the last five years?(Required)

Yes

Please provide full details including dates, descriptions, amounts paid, and current status:(Required)

Has any previous commercial auto insurance been declined, cancelled, or non-renewed?(Required)

Yes

Please explain the circumstances:(Required)

Additional Comments or Special Considerations

by arclight1stg

BOP Quote

Name

This field is for validation purposes and should be left unchanged.

Applicant Information

Applicant Entity Type:(Required)

Individual

Partnership

Corporation

LLC

Joint Venture

Applicant Name:(Required)

Applicant's Name:(Required)

First Last

Applicant's Company Name:(Required)

(N/A if you don't have one)

Applicant Owner's Name:(Required)

First Last

Business Address:(Required)

Street Address Address Line 2 City State ZIP Code

Is business address same as mailing address?(Required)

Yes

Mailing Address:(Required)

Street Address Address Line 2 City State ZIP Code

Phone:(Required)

Fax:

Email:(Required)

Website

FEIN (Tax ID #):(Required)

Does the applicant have a DBA (Doing Business As) name:

In what year did the applicant start operations?(Required)

MM slash DD slash YYYY

Please describe the applicant's day-to-day business operations:(Required)

Main area of practice, type of services provided, products, etc. - Please be detailed

How many years of management experience in this industry does the applicant have?(Required)

Are there any locations or business interests that are owned by the applicant but not shown on the application?(Required)

Yes

If yes, please describe:(Required)

Do you own any business autos?(Required)

Yes

Are there any vehicles that have been customized, altered, or that have special equipment?(Required)

Yes

Are there any vehicles leased to others?(Required)

Yes

Are there high-valued goods, including merchandise at your location?(Required)

Yes

If yes, what is the approximate value of your high-value inventory?(Required)

What is the value of your business personal property? (BPP are all your furniture, computers, printers, etc. Basically, anything you will take with you if you move.)(Required)

Is this entity a franchise?(Required)

Applicant pays for the right to operate under the franchisor's brand and system, the franchisor being the one that owns the brand, products, and business model

Yes

If yes, please describe:(Required)

Number of Locations that the applicant has (in any state):(Required)

Policy Level Underwriting

How many total employees does the applicant have?(Required)

Full Time Employees:

Part Time Employees:

Contractors:

What is the total annual payroll amount for all employees?(Required)

Please list the number of employees and their positions below:(Required)

(For example, Postion: Salesperson, Count: 3)

Position

Count

Total square footage occupied by the insured:(Required)

What is the value of all inventory on hand at any given time?(Required)

This is your contents amount.

Is there a monitored burglar/fire alarm in the store?(Required)

Yes

Please list the type of roof that the building has:(Required)

Does your store/office have a Fire Sprinkler System:(Required)

Yes

What percentage of the building is vacant or unoccupied?(Required)

Please enter a number from 0 to 100.

Has the building undergone a comprehensive renovation since it was originally built?(Required)

This can include gutting to the exterior walls with completely new interior walls, plumbing, heating, wiring, and/or roof.

Yes

Enter most recent renovation type and date:(Required)

MM slash DD slash YYYY

Wiring Year:(Required)

Roofing Year:(Required)

Plumbing Year:(Required)

Heating Year:(Required)

Does the applicant conduct video surveillance at this location?(Required)

Yes

Business Operations

What is the applicant's primary activity/operation?(Required)

(e.g., retail store, office, restaurant, service provider, light manufacturing, contractor)

Are there any other business operations or services provided that are not directly related to the primary activity?(Required)

Yes

If so, please describe in detail:(Required)

Does the applicant operate from a commercial or home-based location?(Required)

Property Coverage Details

Do you own or lease your business property, or both?(Required)

Own

Lease

If leased, what is the square footage occupied and what are the landlord's insurance requirements (e.g., additional insured status, specific liability limits)?(Required)

What is the age of the building?(Required)

What is the building construction type?(Required)

Frame

Masonry

Metal

Other

Year Built:(Required)

Number of Stories:(Required)

Roof Type:(Required)

Total Building Area:(Required)

Total Area Occupied by Insurance:(Required)

Is the property open 24 hours/day:(Required)

Yes

Building Safety Details:(Required)

Automatic Sprinkler System (100% of building)

Central station fire alarm

Private fire department protection service contract

Ansul system over all cooking equipment

Central station burglar alarm

Security guards

Security cameras

Security service making off-hours hourly records

Building square footage occupied by the applicant:(Required)

Estimated building replacement cost (if owned):(Required)

Products

Does the applicant manufacture, distribute, sell, or handle any products?(Required)

Yes

If yes, please list and describe them:(Required)

Are any products imported or exported?(Required)

Imported

Exported

Both

Other

What is the quality control process for products?(Required)

Are there any product warranties provided?(Required)

Have there been any product recalls in the past?(Required)

Yes

If yes, please explain:(Required)

What is the estimated annual sales volume of products?(Required)

Completed Operations/Services

Does the applicant perform any work or services once completed, which could later cause injury or damage?(Required)

(e.g., installation, repair, consulting, construction, cleaning services)

Yes

Please expain:(Required)

What is the typical timeframe from completion of service to potential discovery of a defect/issue?(Required)

Are there any warranties or guarantees provided on services?(Required)

Advertising Activities

What methods of advertising does the applicant use (e.g., print, online, social media, radio, TV)?(Required)

Does the applicant create its own advertising content or use a third-party agency?(Required)

Are there procedures in place to review advertising content for potential copyright infringement, libel, or slander?(Required)

Does the applicant provide advice, consulting, design, or other professional services that, if faulty, could lead to financial harm to a client?(Required)

Describe any professional services offered:(Required)

What are the qualifications and licensing of individuals providing these services?(Required)

Liquor Liability

Does the applicant sell, serve, or furnish alcoholic beverages?(Required)

Yes

What is the percentage of revenue from alcohol sales?(Required)

Please enter a number from 1 to 100.

What are the training procedures for staff (e.g., responsible beverage service)?(Required)

Is the applicant licensed for alcohol sales?(Required)

Yes

Safety and Security

What safety measures are in place to prevent slips, trips, and falls (e.g., clear pathways, non-slip flooring, adequate lighting, wet floor signs, routine cleaning)?(Required)

Are entrances and exits clearly marked and well-maintained?(Required)

Yes

Is there adequate lighting, especially in parking areas or walkways, after dark?(Required)

Yes

Does the building have parking? Please explain:(Required)

(Subterranean, open parking lot attached to building, carports, etc.)

What security measures are in place (e.g., locks, alarms, surveillance cameras, security personnel)?(Required)

Are there any known crime issues in the surrounding area? Please detail:(Required)

Does the applicant have a swimming pool, playground, trampoline, or other recreational facilities on business premises accessible to the public? Please describe:(Required)

Are there any specific hazards on the premises (e.g., forklifts in operation, machinery, chemicals, elevated platforms)? Please elaborate:(Required)

Prior Losses / History

During the last five years, has any applicant been indicted for or convicted of any degree of the crime of fraud, bribery, arson or any other arson-related crime in connection with this or any other property?(Required)

Yes

Has the prospect had a foreclosure, repossession, bankruptcy, judgment or tax lien, business failure or any litigation during the past five (5) years?(Required)

Yes

Have there been any past losses or claims relating to sexual abuse or molestation allegations, discrimination or negligent hiring?(Required)

Yes

Has the prospect had any losses in the past four (4) years (current policy and prior 3 years)?(Required)

Yes

Has any policy or coverage been cancelled or non-renewed during the prior three (3) years for other than non-payment of premium?(Required)

Yes

If so, please explain in detail:(Required)

Workers’ Compensation & Employee Practices

Do you currently have workers’ compensation insurance?(Required)

Yes

Do you provide employee benefits?(Required)

Yes

Do you conduct background checks on employees?(Required)

Yes

Do employees receive safety training?(Required)

Yes

Do you have an Employee Handbook or HR policies?(Required)

Yes

Cyber Liability & Additional Coverage Options

Do you store customer data electronically?(Required)

Yes

Do you process credit card transactions?(Required)

Yes

Have you experienced a data breach in the past five years?(Required)

Yes

Are you interested in adding the following coverages?(Required)

Cyber Liability Insurance

Employment Practices Liability Insurance (EPLI)

Flood or Earthquake Insurance

Equipment Breakdown Coverage

Commercial Auto Insurance

Other coverages

Other coverages:(Required)

Insurance History & Claims

Do you currently have a Business Owners Policy (BOP)?(Required)

Yes

If yes, who is your current insurer?(Required)

Expiration date of current policy:(Required)

MM slash DD slash YYYY

Have you had any insurance claims in the past five years?(Required)

Yes

If yes, please provide details (date, description, type of claim, amount paid, status):(Required)

Additional Comments or Special Considerations

(Please provide any other relevant information that may impact your insurance coverage needs.)

by arclight1stg

Fixed Base Operators Quote

This field is for validation purposes and should be left unchanged.

General Applicant Information

Applicant Entity Type:(Required)

Individual

Partnership

Corporation

LLC

Joint Venture

Applicant Name:(Required)

Applicant's Name:(Required)

First Last

Applicant's Company Name:(Required)

(N/A if you don't have one)

Applicant Owner's Name:(Required)

First Last

What is the corporate name of the applicant? (This is the name that goes on the company’s tax returns)(Required)

Owner's DOB:(Required)

MM slash DD slash YYYY

Owner's Position:(Required)

Business Address:(Required)

Street Address Address Line 2 City State ZIP Code

Is your mailing address the same as your business address?(Required)

Yes

Mailing Address:(Required)

Street Address Address Line 2 City State ZIP Code

Phone:(Required)

Fax:

Email:(Required)

Website:

FEIN (Tax ID #):(Required)

Contact Person:(Required)

Does the applicant have a DBA (Doing Business As) name:

Do you operate at multiple locations:(Required)

Yes

If yes, list all locations:(Required)

In what year did the applicant start operations?(Required)

Is this entity a franchise?(Required)

Applicant pays for the right to operate under the franchisor's brand and system, the franchisor being the one that owns the brand, products, and business model

Yes

Please describe what type of service(s) does the applicant provide:(Required)

Please describe in detail.

Years in business:(Required)

Annual Revenue:(Required)

Number of Employees:(Required)

Full Time:

Part Time:

Contractors:

What are your standard operating hours?(Required)

Do you have any government or military contracts?(Required)

Yes

Do You Operate Under an Airport Lease Agreement?(Required)

Yes

If so, please explain:(Required)

Services Provided (Check All That Apply)

Services(Required)

Aircraft Fueling

Aircraft Maintenance & Repair

Flight Training

Hangar Rental

De-Icing Services

Concierge Services

Aircraft Rental

Aircraft Sales

Charter Services

Tie-Down Services

Ground Handling

Other

Aircraft Fueling: Avg. Gallons Pumped Per Year:(Required)

Other Services(Required)

Facilities

Describe all buildings and structures owned or leased by the applicant (e.g., main terminal, hangars, maintenance shops, fuel farms, offices, retail spaces):(Required)

For Each Building:(Required)

Year Built

Construction Type (e.g., steel, concrete block, frame)

Square Footage

Roof Type

Fire Protection Systems (sprinklers, alarms, fire extinguishers)

What is the replacement cost value of all buildings and contents?(Required)

Are there any tenants or sub-lessees within the applicant’s premises? If so, what are their operations and what are the terms of their lease agreements, particularly regarding insurance requirements?(Required)

What security measures are in place for the premises (e.g., fencing, gates, surveillance cameras, security personnel, lighting)?(Required)

Equipment

List all major ground support equipment (GSE) owned or leased:(Required)

(e.g., tugs, baggage carts, de-icing trucks, lavatory service trucks)

What is the maintenance schedule for all GSE?(Required)

Are all operators of GSE trained and certified?(Required)

Property & Equipment

Do you own or lease your buildings and facilities?(Required)

Own

Lease

Both

Do you own or lease hangars?(Required)

Own

Lease

Both

Total square footage of hangar space:(Required)

Estimated total value of buildings and facilities:(Required)

Do you have a fire suppression system installed?(Required)

Yes

Do you have security measures in place? (Check all that apply)(Required)

24/7 security personnel

Surveillance cameras

Access control system

Fencing and restricted entry

What is the average daily aircraft traffic?(Required)

Are there any special events or airshows hosted or participated in by the applicant? If so, what are the dates, nature of the event, and attendance figures?(Required)

Does the applicant own any mobile fueling or maintenance services off-airport?(Required)

Yes

What products does the applicant sell (e.g., aircraft parts, pilot supplies, fuel, lubricants)?(Required)

Does the applicant perform any maintenance or repair services on aircraft not owned by the applicant? If so, describe the scope of services (e.g., minor repairs, major overhauls, engine work, avionics).(Required)

What is the maximum value of any single product sold or service completed?(Required)

What is the applicant’s quality control program for products and services?(Required)

Are parts tracked (e.g., serial numbers, shelf life)?(Required)

Are all maintenance personnel FAA-certified (e.g., A&P, IA)? What is their experience level?(Required)

What are the warranty terms, if any, for products sold or services rendered?(Required)

Does the applicant operate or utilize any non-owned aircraft for business purposes?(Required)

(e.g., ferry flights, parts pickups, customer transport)

Yes

If so, what type of aircraft, who pilots them, and what are the typical uses?(Required)

Are certificates of insurance obtained from all third-party aircraft operators?(Required)

Security & Safety Management System (SMS)

Does the applicant have a formal Safety Management System (SMS) in place?(Required)

Yes

If yes, describe:(Required)

Who is responsible for safety oversight and compliance?(Required)

How are hazards identified, assessed, and mitigated?(Required)

What is the incident/accident reporting and investigation process?(Required)

What are the emergency response plans for various scenarios?(Required)

(e.g., fuel spill, aircraft fire, medical emergency)

Are regular safety audits or inspections conducted?(Required)

Please note whether they are internal or external.

Aircraft Exposure & Liability

Do you own or operate any aircraft?(Required)

Yes

If yes, please list:(Required)

Do you offer aircraft rental or leasing?(Required)

Yes

Do you provide flight instruction services?(Required)

Yes

Do you require customers to sign liability waivers before services?(Required)

Yes

Do you maintain detailed maintenance and safety records?(Required)

Yes

Employees & Workers' Compensation

How many employees do you have?(Required)

Full-Time:

Part-Time:

Do your employees receive safety training?(Required)

Yes

Do you conduct background checks and drug screening?(Required)

Yes

Do you have a workers’ compensation policy in place?(Required)

Yes

Insurance History & Claims

Do you currently have business insurance coverage?(Required)

Yes

Current Insurer(Required)

Policy Expiration Date(Required)

MM slash DD slash YYYY

Policy Limits(Required)

Have you had any claims in the past five years?(Required)

Yes

If yes, please provide details (date, type of claim, amount paid):(Required)

Has your insurance ever been canceled or non-renewed?(Required)

Yes

If yes, please explain:(Required)

Coverage Needs & Additional Protection

Which types of insurance coverage are you interested in? (Check all that apply)(Required)

Select All

Hangarkeepers Liability

Commercial General Liability

Workers’ Compensation

Professional Liability (For Flight Instructors)

Business Interruption Insurance

Cyber Liability (Data Breaches, Online Transactions)

Pollution Liability (For Fuel Spills)

Other

Other (Please specify):(Required)

Additional Comments or Special Considerations

(Please provide any other relevant information that may impact your insurance coverage needs.)

by arclight1stg

Private Events Quote

Instagram

This field is for validation purposes and should be left unchanged.

Personal Information

Full Name:(Required)

First Last

Date of Birth:(Required)

MM slash DD slash YYYY

Gender:(Required)

Male

Female

Other

Marital Status:(Required)

Single

Married

Divorced

Widowed

Home Address:(Required)

Street Address Address Line 2 City State ZIP Code

Phone Number:(Required)

Email Address:(Required)

Name of other individual(s) or group(s) taking part or in sponsoring this event:

General Information

Type of Event:(Required)

Beer Garden / Beer Tent

Car Show

Company Picnic

Competition or Shows

Festival

Wedding / Wedding Event

Concert/Musical

Convention/Trade Show

Parade

Party / Social Event

Fund Raiser

Performance Festival

Picnic

Political Events

Sporting Event / Tournament

Individual Vendor Booth

Other

Other:(Required)

Location address of event:(Required)

Street Address Address Line 2 City State ZIP Code

Location is:(Required)

Arena

Fairgrounds

Public Park

Stadium

Convention Center

Private Residence

Other

If the applicant is not taking part in or sponsoring the event, what is the relationship to the event?

Event is being held:(Required)

Indoors

Outdoors

Date of Event(Required)

MM slash DD slash YYYY

Time of Event(Required)

Desired Coverage Dates

Maximum Daily Attendance(Required)

Total Attendance(Required)

Do participants sign waiver of liability agreements?(Required)

Yes

Is there an admission fee?(Required)

Yes

If yes, what’s the price of admission?(Required)

Is admission:(Required)

General Admission

By Invitation Only

Is applicant an event coordinator?(Required)

Yes

Will there be any heavy machinery used such as bulldozers, backhoes, excavators, or any other type of industrial machinery (small forklifts and light machinery are acceptable)?(Required)

Yes

Do you require vendors to provide you with a Certificate of Insurance?(Required)

Yes

Are you named as an additional insured?(Required)

Yes

Are there any water hazards present:(Required)

Swimming Pool

Lake

Pond

Other

Other(Required)

Animal Exposure

Will there be exposure to animals at the event?(Required)

Yes

Are there animal rides?(Required)

Yes

If yes, list the type of animals:(Required)

Are there any safety measures used?(Required)

Yes

If yes, please describe:(Required)

Is there a petting zoo?(Required)

Yes

List the type of animals:(Required)

Is the area supervised?(Required)

Yes

Athletic Event

Is this an athletic event?(Required)

Yes

Number of participants:(Required)

Age of Participants:(Required)

Number of games:(Required)

Is coverage desired for participants?(Required)

Yes

Describe distance and protection between spectators and participants:(Required)

Bicycle / Running Event

Is this a bicycle / running event?(Required)

Yes

Is the route surface free of hazards and clearly marked?(Required)

Will all pedestrians and vehicular traffic be rerouted?(Required)

Entertainment

Will live entertainment be provided?(Required)

Yes

Is event a rave, rave dance, or rave party?(Required)

Yes

Any celebrities to be present?(Required)

Yes

If yes, provide names:(Required)

Name of performer or group:(Required)

Any special effects for the concert:(Required)

Yes

If yes, describe:(Required)

Fireworks

Will your event involve fireworks?(Required)

Yes

Will there be a fireworks display?(Required)

Yes

Will a licensed technician ignite the fireworks?(Required)

Yes

If no, advise who will ignite them:(Required)

Is the person igniting the fireworks insured for this operation?(Required)

Yes

Will firemen be present?(Required)

Yes

Will an ambulance be on hand?(Required)

Yes

Will fireworks be sold?(Required)

Yes

First Aid

Will first aid facilities be provided at the event?(Required)

Yes

If yes, describe:(Required)

Who will be charge of the facilities:(Required)

Liquor and Food

Is liquor to be served by applicant?(Required)

Yes

Served by Caterer

If yes, describe:(Required)

Is BYOB (Bring your own bottle) or self-service of alcohol permitted?(Required)

Yes

If yes, describe:(Required)

Is liquor required to be served by others?(Required)

Yes

Is applicant required to have a valid liquor license for the event?(Required)

Yes

Estimated number of attendees consuming alcohol daily:(Required)

Food sold or served by applicant?(Required)

Yes

Sold/Served by Caterer

If you have a caterer, do they have existing insurance?

Yes

Other

If so, with what carrier?(Required)

Parking Facilities

Will you provide parking at the event?(Required)

Yes

Operated by:(Required)

Applicant

Other

If others, do they have their own insurance?(Required)

Yes

Is parking area:(Required)

Paved

Dirt

Other

Rides / Attractions

Will inflatables be utilized?(Required)

Yes

Will rides be provided?(Required)

Yes

If yes, type of rides:(Required)

Are the rides supervised at all times?(Required)

Yes

Is the applicant property licensed to operate equipment?(Required)

Yes

Does the vendor or subcontractor operate kiddie rides?(Required)

Yes

Does the applicant have certificates of insurance from the ride or inflatable vendors?(Required)

Yes

Security and Traffic Control

Is there a written emergency plan in the event of an accident?(Required)

Yes

Does an independent security company provide a certificate of insurance?(Required)

Yes

Who is responsible for crowd and traffic control?(Required)

Are parking areas smooth with clearly marked parking areas and exit roads?(Required)

Yes

Insurance Questions

Does the venue have existing insurance?(Required)

Yes

If so, what carrier?(Required)

Does the individual or company running this event have liability insurance?(Required)

Yes

If so, of what kind and with what carrier?(Required)

What kind of insurance are you looking to acquire for this event (general liability, slip and fall, property, etc.)?(Required)

Will you need to list the location or any others as additional insured?(Required)

Yes

If so, who?(Required)

Additional Information

Use the space below to provide any other relevant information or special considerations that may affect your insurance policy.

by arclight1stg

Commercial Property Quote

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This field is for validation purposes and should be left unchanged.

Applicant Information

Applicant Entity Type:(Required)

Individual

Partnership

Corporation

LLC

Joint Venture

Applicant Name:(Required)

Applicant's Name(Required)

First Last

Applicant's Company Name:(Required)

(N/A if you don't have one)

Owner's Name(Required)

First Last

Business Address(Required)

Street Address City State ZIP Code

Is the business address the same as the mailing address?(Required)

Yes

Mailing Address(Required)

Street Address City State ZIP Code

Phone(Required)

Fax

Email(Required)

Web Address:

FEIN (Tax ID #):(Required)

Does the applicant have DBA (Doing Business As) name:

In what year did the applicant start operations?(Required)

Please describe the applicant's day-to-day business operations:(Required)

Main area of practice, type of services provided, products, etc. - Please be detailed

How many years of management experience in this industry does the applicant have?(Required)

Are there any locations or business interests that are owned by the applicant but not shown on the application?(Required)

Yes

If so, please list locations/interests:(Required)

Does applicant own any business autos?(Required)

Yes

If there are business autos, please provide details:(Required)

Are there any vehicles that have been customized, altered, or that have special equipment?(Required)

Yes

If so, please list customizations:(Required)

Are there any vehicles leases to other?(Required)

Yes

Are there high-valued good, including merchandise at your location?(Required)

Yes

If yes, what is the approximate value of your inventory?(Required)

What is the value of your business property? (BPP are all your furniture, computers, printers, etc. Basically, anything you will take with you if you move)(Required)

Property Details

Building Type:(Required)

Office

Retail

Warehouse

Manufacturing

Restaurant

Other

Total square footage occupied by the applicant:(Required)

Total number of buildings:(Required)

Year built:(Required)

Number of floors in the building:(Required)

Does property have a parking lot or garage?(Required)

Yes

What is the area of the lot/garage? (in square feet)(Required)

Type of Construction(Required)

Frame

Masonry

Metal

Concrete

Other

Type of Roof (e.g., TPO, EPDM, built-up, shingles, metal):(Required)

What year was the roof last replaced/updated?(Required)

What year was the electrical wiring last updated/inspected?(Required)

What type of wiring is it?(Required)

Copper

Aluminum

Knob and Tube

Other

What year was the plumbing last updated/inspected?(Required)

Type of pipes (e.g., copper, PVC, galvanized)?(Required)

What year was the heating/HVAC last serviced/replaced?(Required)

What type of heating system is it (e.g., central furnace, boiler, electric heat)?(Required)

Does your property have a Fire Sprinkler System?(Required)

Yes

Is there a fire alarm system?(Required)

Yes

Is the system monitored by a central station?(Required)

Yes

What is the distance to the nearest fire hydrant?(Required)

What is the distance to the nearest fire station?(Required)

What is the Public Protection Class (PPC) for the location (a 1-10 rating, where 1 is best)?(Required)

Please enter a number from 1 to 10.

Are fire extinguishers readily available and regularly inspected?(Required)

Does the building have a security system?(Required)

Yes

Describe the security measures (e.g., camera, guards, keycard access):(Required)

Who is responsible for the care and maintenance of the property (building, sidewalks, parking lots)?(Required)

What is the estimated replacement cost of the building?(Required)

Do you own or lease any additional structures (storage unit, detached buildings, etc.)(Required)

Yes

If yes, please describe:(Required)

Business property & Contents Coverage

What is the requested replacement cost value (RCV) of the building(s)? (This should be based on current construction costs, not market value):(Required)

Descrribe the overall condition of the building, including the exterior, roof, interior, and foundational elements:(Required)

What is the regular maintenance schedule for the building systems (e.g., HVAC, plumbing, electrical)?(Required)

Are there any known deferred maintenance issues or structural problems?

What is the estimated value of business personal property (equipment, inventory, furniture, etc.)?(Required)

Do you have specialized equipment or high-value items that require additional coverage?(Required)

Yes

If yes, please describe:(Required)

Are contents primarily at the main business address, or are there other locations where property is stored or used? Please specify:(Required)

What is the requested replacement cost value (RCV) of your business personal property?(Required)

Does this value fluctuate significantly (e.g., seasonal inventory)? If so, what are the peak and off-peak values?(Required)

Do you store hazardous materials or flammable substances on-site?(Required)

Yes

Please specify:(Required)

Does the applicant rely on specialized machinery for daily operations?(Required)

Yes

Do you have backup power sources (e.g., generators)?(Required)

Yes

Property Use & Operations

Does the building have multiple tenants?(Required)

Yes

If so, what kind of businesses do they have?(Required)

Underwriters need to know about your co-occupants due to potential shared exposures.

What percentage of the building do you occupy?(Required)

Please enter a number from 1 to 100.

Are there any vacant units in the building?(Required)

Yes

What percentage of the building is vacant?(Required)

Please enter a number from 1 to 100.

What is the primary use of the building? (check all that apply)(Required)

Office Space

Retail Sales

Manufacturing

Third Party Processors/Harvesters

Restaurant/Food Service

Wholesale/Distributors

Laboratories

Management Offices

Indoor/Greenhouse

Storage/Warehouse

Other (please specify)

Other uses:(Required)

Are any structural renovations or repairs planned in the next 12 months?(Required)

Yes

Please describe plans:(Required)

Are there any existing structural issues or damages to the property?(Required)

Yes

Please describe issues:(Required)

Do you lease any part of the property to others?(Required)

Yes

Please describe leases:(Required)

Does the applicant rely on another location for storage, production, or operations?(Required)

Yes

Please explain location(s):(Required)

Safety and Security

What specific protective safeguards are in place and routinely maintained (e.g., alarm systems, sprinkler systems, automatic extinguishing systems, security guards)?(Required)

Are there any monitoring contracts in place for these systems?(Required)

What is the procedure for testing and maintenance of these safeguards?(Required)

Business Interruption & Extra Coverage

Would the applicant suffer a financial loss if the property were damaged and operations had to stop?(Required)

Yes

What is your estimated monthly revenue?(Required)

What is your estimated time required to resume full operations if a major loss occurs?(Required)

Less than 30 days

30-60 days

60-90 days

More than 90 days

Do you have a contingency plan in place for business disruptions?(Required)

Yes

Future Construction Activity

Will there be construction activities during the policy term?(Required)

Yes

What is the scope of work and general timeframe?(Required)

What are the projected construction costs?(Required)

Will a general contractor be hired?(Required)

Yes

Is the general contractor required to carry their own Commercial General Liability coverage?(Required)

Yes

Additional Coverages & Endorsements

Would you like to include coverage for the following? (Check all that apply)(Required)

Equipment Breakdown Coverage

Spoilage Coverage (for perishable goods)

Utility Services Interruption Coverage

Ordinance or Law Coverage (for compliance with updated building codes)

Flood or Earthquake Coverage

Cyber Liability Coverage

Employee Theft Coverage

Insurance History & Claims Information?

Do you currently have commercial property insurance?(Required)

Yes

Current Insurer(Required)

Policy Expiration Date(Required)

MM slash DD slash YYYY

Current Policy Limits(Required)

Have you had any property insurance claims in the past five years?(Required)

Yes

If yes, please provide details of your claim(s) (date, description, current status, type of claim, amount paid):(Required)

Has the applicant ever had insurance coverage canceled or non-renewed?(Required)

Yes

Please explain:(Required)

Additional Comments or Special Considerations

(Please provide any other relevant information that may impact your insurance coverage needs.)

by arclight1stg