Concessionaires Online Quote

Agent Information

Agency Name or Agent Lookup Code

-OR-

Agent Lookup Code

Phone:

Fax:

Agent Email:

Agency's Mailing Address

Agency City

Agency State

Agency Zip

Insured Information

Insured Name:

Insured Email:

Insured's Mailing Address

Suite, Unit, Floor, etc. (Optional)

Insured's City

Insured's State

Insured Zip

Is Location Address same as Mailing Address? (Click if Yes)

Location Address

Suite, Unit, Floor, etc. (Optional)

Location City

Location State

Location Zip

Risk Details

What type of vendor is the insured?:

Length of term:

How Many Locations?

Provide detail of operations (including products sold):

Limit required:

Does applicant park at a specific location (public street, school campus, fairs/carnivals, etc.) for at least one (1) hour selling to customers?

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 trucking units are required?

Number of Christmas Tree Lots

Number of Pumpkin Patches

Number of Seasonal Tents

Number of Flower Tents

Number of Kiosks, Push Carts, Tables or Booths:

Is operation related to valet parking services, tow trucks, airline catering or off-shore catering? (Click if Yes)

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)

How many losses in the past 3 years?

Has any loss exceeded $2,500 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:

Physical Damage

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)

Physical Damage Deductible:

Are vehicles rented each time there is a job?

Does insured lease, loan, or rent any of the equipment to others?

Has applicant had previous Physical Damage Insurance cancelled? (Click if Yes)

Trailer 1

Is the trailer owned by the insured?

Trailer Type:

Year:

Make:

Trailer Stated Amount or ACV (Whichever is Less) ($):

Is the Vehicle Identification Number (VIN) for the trailer known?

VIN:

Inland Marine

Does the Insured need coverage on Owned Inventory? (Click if Yes)

* Maximum limit available online - $5,000

Inventory Value: $

Inventory Description:

* Maximum limit available online - $15,000

Commission

What commission would you like for this account?

Additional Comments

Additional Comments:

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For higher limits or coverage options not listed, please contact Commercial Department, Ext 200.

Any questions or problems with the form? Please contact Commercial Department

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

Caterers / Concessionaires / Push Carts / Food Truck Online Quote