Request a Commercial Property Quote

Commercial Property Insurance Quote
Policy Holder Information
Legal Entity Name
Business Name / dba
Please provide a brief description of the nature of your business
Mailing Address
City, State and Zip
Telephone Number
Fax Number
E-Mail Adddress
Estimated Annual Gross Sales/Rents
Property Coverage Information
Physical Address
City, State and Zip
Name and Telephone of Person to Contact for Inspection
Square Footage of Building
Construction Type
Does Building have a Central Station Alarm?
Replacement Cost of Building
Replacement Cost of Contents
Desired Deductible Amount
Location #2 Coverage Information (if more than one location)
Physical Address
City, State and Zip
Name and Telephone of Person to Contact for Inspection
Square Footage of Building
Construction Type
Does Building have a Central Station Alarm?
Replacement Cost of Building
Replacement Cost of Contents
Property Update Information
Date of latest roof upgrade or repair work	Location 2
Date of latest electrical upgrade or repair work	Location 2
Date of latest plumbing upgrade or repair work	Location 2
Year originally built	Location 2

Lienholder Information
Will a Landlord/Owner be named as Loss Payee?

Name of Landlord/Owner
Mailing Address
City, State, Zip
Other Information
Any claims in the past 3 years? If yes, please provide the number of prior claims and amount paid for each.

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*In Kona...* 75-5931 Walua Road Kailua Kona, HI 96740 Phone: 808-334-0044 Fax: 808-334-0115 Toll Free: 800-483-0333		*In Kailua...* Pali Palms Business Plaza 970 N. Kalaheo Ave., Ste A203A Kailua, HI 96734 Phone: 808-254-1818, Fax: 808-254-2121

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