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Guard Insurance 6400 Laurel Canyon Blvd. Suite 305
North Hollywood, CA 91606
Phone. 818.789.0722
Fax. 818.789.2835
Agent of Business Insurance, Workers Compensation, Auto Insurance, BOP, Property Insurance, Health Insurance, Homeowners Insurance, Commercial Property and more.
Business Owners Policy / General Liability / Business Package Insurance Quotes
Business Owners Policy quote
Owner/ CEO Name
Contact Name
If Different From Above
Business Name
Mailing Address
Mailing Address 2
City, State Zip ,
Business Type
Company FEIN or Owner SS#
Email Address
Contact Phone Number
Business Information
Nature of Business
Currently Insured Expiration Date Gross Annual Income
  Carrier Name Policy Number Loss Run If Available
Current
1'st Prior
2'nd Prior
3'rd Prior
Please Explain Any Losses
Locations requesting coverage
  • Location 1
  • Location 2
  • Location 3
  • Location 4
  • Location 5
Address
Address 2
City, State Zip ,
Description of Operations
on Premises.
Inventory / Contents
Building Value
Loss of Rent / Income
Deductible

Building Info:
Construction Type:  Roof Type:
Year Built:  Sq Ft: Sq. Ft. Garage: Num of Floors:
Fire Protection: Sprinklered Non-Sprinklered

Building Improvements:
  Fully
Updated		 Partially
Updated		 Year
Improved
Heating
Electrical
Roofing
Plumbing

Does Building have a central Alarm?  Yes No
If yes, who installed it and can you provide a certificate?
Address
Address 2
City, State Zip ,
Description of Operations
on Premises.
Inventory / Contents
Building Value
Loss of Rent / Income
Deductible

Building Info:
Construction Type:  Roof Type:
Year Built:  Sq Ft: Sq. Ft. Garage: Num of Floors:
Fire Protection: Sprinklered Non-Sprinklered

Building Improvements:
  Fully
Updated		 Partially
Updated		 Year
Improved
Heating
Electrical
Roofing
Plumbing

Does Building have a central Alarm?  Yes No
If yes, who installed it and can you provide a certificate?
Address
Address 2
City, State Zip ,
Description of Operations
on Premises.
Inventory / Contents
Building Value
Loss of Rent / Income
Deductible

Building Info:
Construction Type:  Roof Type:
Year Built:  Sq Ft: Sq. Ft. Garage: Num of Floors:
Fire Protection: Sprinklered Non-Sprinklered

Building Improvements:
  Fully
Updated		 Partially
Updated		 Year
Improved
Heating
Electrical
Roofing
Plumbing

Does Building have a central Alarm?  Yes No
If yes, who installed it and can you provide a certificate?
Address
Address 2
City, State Zip ,
Description of Operations
on Premises.
Inventory / Contents
Building Value
Loss of Rent / Income
Deductible

Building Info:
Construction Type:  Roof Type:
Year Built:  Sq Ft: Sq. Ft. Garage: Num of Floors:
Fire Protection: Sprinklered Non-Sprinklered

Building Improvements:
  Fully
Updated		 Partially
Updated		 Year
Improved
Heating
Electrical
Roofing
Plumbing

Does Building have a central Alarm?  Yes No
If yes, who installed it and can you provide a certificate?
Address
Address 2
City, State Zip ,
Description of Operations
on Premises.
Inventory / Contents
Building Value
Loss of Rent / Income
Deductible

Building Info:
Construction Type:  Roof Type:
Year Built:  Sq Ft: Sq. Ft. Garage: Num of Floors:
Fire Protection: Sprinklered Non-Sprinklered

Building Improvements:


  Fully
Updated		 Partially
Updated		 Year
Improved
Heating
Electrical
Roofing
Plumbing

Does Building have a central Alarm?  Yes No
If yes, who installed it and can you provide a certificate?


 
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