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*indicates required fields *Franchise (Must specify) American Speedy Printing Centers Inc. Arby's Ask Mr Foster Associates Inc. Athlete's Foot Marketing Associates Inc. Athletic Attic Marketing Inc./Athletic Lady Baskin Robbins Inc. Bathique International Inc. Blimpie's Breslers' 33 Flavors Inc. Brown's Chicken Burger King Business Cards Tomorrow Inc. Cajun Joe's Premium Chicken Command Performance Cookie Factory of America Inc. Cost Cutters Family Hair Care Shops Cousins Captain D's Dairy Queen Deck the Walls Docktor Pet Centers Inc. Fantastic Sam's, The Original Family Haircutters Fashion Crossroads Flowerama of America Inc. Franklin Copy Service Inc. Gingiss International Inc. Grandy's Great American Chocolate Chip Cookie Inc. Great Expectations Precision Haircutters Haircutters Hardees Health Mart Inc Hickory Farms of Ohio Insty-Prints Inc. Ken's Pizza Kentucky Fried Chicken La Femmina Beauty Salon Lee's Famous Recipe The Lemon Tree Little Caesar's Pizza Little Professor Book Centers Long John Silver's Maid Rite Products Martin Franchises Inc. (One Hour Martinizing) Mazzio's Pizza Medicine Shoppe International Inc. Mode O'Day Company MotoPhoto Inc. Mr. Gatti's Inc. Mr. Hero (Restaurant Developers Corp.) Mr. Philly (Restaurant Developers Corp.) NuVision Optical Pearle Vision Centers Petland Inc. Popeye's Famous Fried Chicken Postal Instant Press Print Shack International Inc. Quik Print of Kansas Inc. Rally's Inc. Rax Restaurants Inc. Roy Rogers Schlotzsky's Inc. Subway (Doctor's Associates Inc d/b/a) Supercuts Swiss Colony Stores Taco Bell Taco Time International Inc. TCBY Enterprises Inc.(The Country's Best Yogurt) Wendy's Wicks 'N' Sticks Co. Zack's Famous Frozen Yogurt Inc. Other *Contact Name *E-mail Company *Address *City County State *Zip Code Home Phone Work Phone FAX   Address City County State ZipCode   Year Built Construction Type Stucco/Masonry Frame (predominantly wood) Non-Combustible Building Type 1 to 4 Stories 5 Stories & over Basement Type None Unfinished Basement Partially Finished Basement Finished Basement Air Conditioning No Air Conditioning Window Air Conditioners Central Air Conditioning Parking Type Carports Garage or ground level parking under roof Underground parking Enclosed Parking Sq.Footage Building Sq.Footage Elevators Yes No Building Owner Occupied Yes No Loss of Income/Rents Yes No Building Sprinklered Yes No Enclosed Access? Yes No   Building Coverage Contents Coverage Liability Limits $100,000 $300,000 $500,000 $1,000,000 $2,000,000 Deductible Options $500 $1,000 $2,500 $5,000 $10,000 Fire Legal $100,000 $300,000 $500,000 Property of Others Exterior Signs All Exterior Glass Employees at Location Full Time Part Time Employee Dishonesty None $5,000 $10,000 $20,000 $30,000 $40,000 $50,000 Spoilage None $2,500 $5,000 $7,500 $10,000 $20,000 $30,000 $40,000 $50,000 Earthquake Yes No Building Laws Yes No Water Damage Yes No Hired Auto Yes No Employer's Non-Owned Auto Yes No Heating & Air Conditioning Equipment Basic Broad Heating Boilers     Have you had any home or contents losses within the last three years? If yes, please explain in remarks below: REMARKS:   Current Insurance Expiration Date   How would you like to receive your free quote? U.S.Postal E-mail Fax