Commercial Insurance
Employee Benefits
Personal Insurance

New Salon Questionaire

Applicant:

Applicant Name:

Name of Salon:

Phone #:

Email:

Mailing Address:

Street:

City:

State:

Zip:

Street Address:

Street:

City:

State:

Zip:

Experience:

How long in business?

How many years experience doing nails?

How many Nail Techs full-time?

How many Nail Techs part-time?

Estimated Annual Receipts:

What kind of services do you perform?

Policy:

Desired Policy Period? From:

How much coverage on contents in salon?
(must be at least 25,000)

Business Type:

Business Location Information:

Business Located in:

Leased Space
Free Standing Building

Applicant is:

Building owner
Tenant

Construction of Building:

Sprinkler System:

Yes

Sq. Feet of Insured's Premises:

Distance to responding Fire Dept:

Additional Insured:

Details of Additional Insured:

Prior Insurance Carrier and Loss History (3 years):

* In order for applicant to get coverage, they must provide us with documentation that there have been no losses.

* When coverage is bound, insured must sent 2 checks, one for agency service fee & one to company for premium.