Phone:

804-359-4568

Toll Free:

800-396-6226

Fax:

804-359-6994

E-Mail:

info@commund.com

Caterers / Concessionaires / Push Carts / Food Truck Online Quote

Please complete the following and press submit or call 800-396-6226 x202 for an instant phone quote

Agent Information
Commonwealth Underwriters Agent Code: *Note: this field is optional*

Agency Name:
Agent Name:
first and last name
Phone:
999-999-9999 format
Fax:
999-999-9999 format
Agent Email:
(A copy of the quote will be sent to this address)
Insured Information
Insured Name:
Insured Email: (will only be used to communicate regarding this account)
Insured's Mailing Address
Insured Zip
Is Location Address same as Mailing Address? (Click if Yes)
Location Address
Location Zip
Would you like a finance quote? (Click if Yes)
* Financing is not available for a 3 or 6 month term.
Agency's Mailing Address
Agency City
Agency State
Agency Zip
Risk Details
Length of term:
What type of vendor is the insured?:
Provide detail of operations (including products sold):
Limit required:
Does applicant have Auto Liability Coverage?
Auto Liability Limit:
Limit Required:
Total receipts (in dollars): $
Years in business:
Years of experience:
Description of catering operations:
Condition of catering equipment:
Have employees been thoroughly trained?
Will any liquor be served?
* Quote will be Submitted for Underwriter Approval
Total liquor receipts (in dollars): $
How many trailer units are required?
How many trucking units are required?
Is operation related to valet parking services, tow trucks, airline catering or off-shore catering? (Click if Yes)
Number of Kiosks, Push Carts, Tables or Booths:
Number of Kiosks, Push Carts, Tables or Booths:
Number of Kiosks, Push Carts, Tables or Booths:
Number of Kiosks, Push Carts, Tables or Booths:
Does the Insured require hired or non-owned auto coverage? (Click if Yes)
Does the Insured sell any health or dietary supplements? (Click if Yes)
Does the Insured sell children's toys/dolls, non-food products (manufactured by the insured), or alcohol? (Click if Yes)
Have there been any losses in the last 3 years? (Click if Yes)
Has there been more than one loss in the last 3 years? (Click if Yes)
Has any loss exceeded $10,000 in the last 3 years? (Click if Yes)
Is the Insured the owner of the flea market, also operating as a vendor? (Click if Yes)
Are there any additional insureds? (Click if Yes)
Type of additional insureds:
Number of additional insureds:
Inland Marine
Does the Insured need coverage on Owned Inventory? (Click if Yes)
Inventory Value: $
* Maximum limit available online - $5,000
Inventory Description:
Does the insured need physical damage coverage on a concession trailer (including equipment)? (Click if Yes)
Is this a new venture? (Click if Yes)
Is the equipment licensed for road use? (Click if Yes)
Equipment Value: $
* Maximum limit available online - $15,000
Commission
What commission would you like for this account?
Additional Comments
Additional Comments:




For higher limits or coverage options not listed, please contact Cindy Rios, Ext 127.

Any questions or problems with the form? Please contact Cindy Rios



Only Commonwealth Underwriters, Ltd. has binding authority. Coverage will not be bound until application has been received, reviewed, and accepted by Commonwealth Underwriters, Ltd.