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Hotel/Motel Quote Form

Fill out the following form as completely as possible. Once you have completed the form, click the Submit button to send your information. Your request will be handled promptly.

First Name *

Last Name *

Primary Phone Number *

E-Mail Address *

Applicant *

Applicant (Entity) Name *

Hotel / Motel Name *

Location Address *

City *

State *

ZIP / Postal Code *

Federal ID #: *

County *

Mailing Address

City *

State *

Zipcode *

No. of Buildings *

Total Buildings Value *

Total Contents Value *

Total sign Value *

Total No. Of Units *

No. of Story *

Construction Type *

Sprinkler System *

Swimmming Pool *

Restuarant On Premises

Lounge on Premises

Restaurant & Lounge Leased to Others

Gross Room Ravenue *

Gross Restaurant & Lounge Revenue *

Any Update for Plumbing, Electrical, Roof, Heating *

Update Year *

Total Payroll (Hotel)

Commercial Vehicle Owned by Hotel

Submission Validation

Required

Important Notice
Any submissions or payments made via this website do not constitute a binding agreement to your policy or coverages. Changes and payments to policies are not effective or binding until you, or any party involved, receive official notice from either your insurance agent, or your insurance company. If you have any questions, please feel free to contact us.

Per the terms of our online privacy policy we will not resell your information to any third-party.

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