Prestige Insurance Brokers Inc. - North Battleford, Saskatchewan

Powerful Protection, Priced Right - Home, Farm, Auto, Life, & Travel Insurance


Name:
Email Address:
Address:
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Age of building:
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Is the building sprinklered?	Yes No
How much area do you occupy?
Are you the only tenant?	Yes No
Is there a hydrant within 500 ft. (150 metres)?	Yes No
Is there a fire hall within 3 miles (5 kms)?	Yes No
Has insurance ever been denied or canceled?	Yes No
What type of business?
How many years in the business?
Have there been any insurance claims in the last 3 years?
What are the annual receipts?
What is the annual payroll?