Home > My Music Business > Music Stores > Insurance Quote for Music Store Owners Insurance Quote for Music Store Owners The information requested on this form will allow us to request a premium indication from multiple insurance carriers on your behalf. Should you choose to accept one of these quotes, a formal application with your signature will need to be completed. Full Legal Name of Business*Business Entity*LLCSole ProprietorPartnershipCorporationDBAFederal ID NumberYour Name First Last Mailing Address* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Is the location address the same as the mailing address?Yes / Not applicableNo, it is differentLocation Address Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Phone*FaxEmail* Date Your Current Business Started Date Format: MM slash DD slash YYYY If you don't know the exact day, use the 1st of the month in the proper year.Date quote is needed by? Date Format: MM slash DD slash YYYY Do you have a current business insurance policy?YesNoCurrent Insurance InformationCurrent Business Owner's Insurance CarrierCurrent Insurance PremiumExpiration Date of Current Policy Date Format: MM slash DD slash YYYY Have you had any losses or claims in the last 5 years on your business policy?YesNoIf yes, please give a description of the loss, the date of the loss, the amount paid and whether the claim is now open or closed.*Property InformationDo you own the building or lease/rent the office space?Own the buildingLease / Rent the spaceWhat is the building value?How much is it insured for on your current policy?Year BuiltSquare Footage of BuildingSquare Footage You OccupyNumber of StoriesAre there other occupant businesses? Please list them below Construction TypeMasonryFrameMasonry with wood joistsYear of most recent updates to the:RoofHeatingElectricalPlumbingType of HeatIf boiler, please describe and give age.Is the building 100% sprinklered?YesNoIs there a burglar alarm?*Select...NoYes, local alarmYes, central station alarmIs there a fire alarm?*Select...NoYes, local alarmYes, central station alarmStore InformationValue of business personal propertyi.e. equipment, office furniture, supplies, computersValue of retail stockAnnual Gross Sales% of business from rentals% of business from repairs% of business from lessons% of business from internet salesMax value of items being shipped at any given timeHow are items shippedSelect...Your vehiclesCommon carrier (UPS, FedEx, etc.)Deductible on current policyDo you have a mortgage on the building or a loss payee on the business or business equipment? If so, please give full name and addressAre there any other additional insureds that should be listed? (i.e. landlord)If so, whom?
