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Ralph Talanian Insurance Agency

3 Union Street
South Weymouth, MA 02190-2399

Phone: (781) 335-3225 Fax: (781) 335-4383

Email: bryan@talanianinsurance.com

Please fill in the form below if you would like us to get back to you.

Business Owners Package (BOP) Insurance Quote

General Information
Your Full Name:
Your Company:
Address:
City:   State:   Zip:
Business Phone:   Fax Number:
E-mail Address:

Current Insurance Information
Company Name:
Policy Expiration Date:  
Types of coverage you currently have:  
Bonds
Auto
Property & Liability 		Workers Comp
Directors & Officers
Group Life & Health		 Prof. Liability
Other

About Your Business
No. of full-time employees:

No. of part-time employees:
Years in business:

No. of locations:

Annual Sales:


Complete description of your operations:


Property Questions
Age of building
or Year Built:
Type of building
construction:
Number of
stories:
Other
occupancies:
Square feet
you occupy:
sq. ft.
If the building is over 25 years old, please answer the following:

Year Electricity was updated:

Is it on circuit breakers?:


Yes   No
Year Plumbing was updated:

Copper or Galvanized plumbing?:


Copper   Galvanized  
Other:
Year Building was last re-roofed:

Type of roofing material:



Protective Devices
Burglar Alarm:
Central Station
or local alarm?:
Name of
alarm company:
Is the building
sprinklered?:
Are there
smoke detectors?:
Yes  No
  Central Station
  Local Alarm
Yes   No
Yes   No


Liability Questions
Please provide information on previous insurance carrier:
Previous Ins. Carrier:
Policy number:
Prior premium:
Policy renewal date:
$
Please provide information about your business:
Years in business:
Projected Gross annual receipts:
Projected annual payroll:
$
$
   


Coverage Limits
Building:
Contents
(equipment, inventory, supplies, etc.):
Deductible:
Loss of Income:
$
$
$
Money and Securities:
Glass or signs:
General Liability Limit:
Non-owned and Hired
Automobile Liability:
Is liquor liability needed?
$
$
Yes   No
Yes   No
    If Glass Coverage is needed, please provide dimensions:
    Please list other coverages you may need:


Miscellaneous Information
Name of Additional Insured
(Landlord or vendor):
Mailing Address:
City:   State:   Zip:


Additional Comments


Please click the "Submit Quote" button to send your quote request.

No coverage is in effect until bound by an insurance carrier. This is a request for quotation only.

Thank you!  We will email or call you with a quote for your Business Owners Package Insurance Quote.