Donoyan Insurance Agency Inc.

 

After completing this form, please click the SUBMIT button to receive your free Insurance Quote.

You'll be given an opportunity to specify U.S. Postal Service, e-mail or fax.
Or call us toll-free at 877-DONOYAN (366-6926).

*indicates required fields
*Service Business

*Contact Name
*E-mail
*Company
*Address
*City
County
State
*Zip Code
Home Phone
Work Phone
FAX

 
Address
City
County
State
Zip Code

 
Year Built
Construction Type
Building Type
Basement Type
Air Conditioning
Parking Type
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
Deductible Options
Property of Others
Exterior Signs
Number of Operators
(Barber & Beauty Shops)
Employees at Location
 Full Time Part Time
Employee Dishonesty
Spoilage
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

 
Current Insurance
Expiration Date
   

Have you had any building losses within the last three years?

 

 
Current Insurance

Expiration Date

 
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 U.S.Postal E-mail Fax


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