Authorized Agent of Travelers Insurance Company, The Hartford, Safeco Insurance, Golden Eagle Insurance, Sequoia Insurance Company, Midwest Insurance Company, Anthem Blue Cross of California, Blue Shield of California, Aetna Health, Progressive Casualty Insurance Company, Century National Insurance Company, National Interstate Insurance Company, plus over 100 other carriers in a wide array of markets!
 
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 Property Insurance Quotes
Commercial Property quote
First and Last Name
Business Name
Mailing Address
Mailing Address 2
City, State Zip ,
Business Type
Company FEIN or Owner SS#
Email Address
Contact Phone Number
policy history: prior 3 years
Carrier Policy # Effective/ Expiration Dates Liability Limits

Any Claims or Losses?   Yes  No
If Yes Please Explain:

Please attach the last 3 years of updated loss run.
Locations requesting coverage
  • Location 1
  • Location 2
  • Location 3
  • Location 4
  • Location 5
Address
Address 2
City, State Zip ,
Description of Operations
on Premises.
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.
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.
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.
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.
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?


 
Copyright © 2010 Guard Insurance Brokers, Inc - CA License# 0B45302- All rights reserved