Commercial Property Insurance from Insurance Network of Louisiana

Contact Information

First Name ✶

Last Name ✶

Phone

Email

Title

Business Information

Location

Business Name ✶

Street Address ✶

City ✶

State ✶

ZIP ✶

How do you occupy the property?

If “Other,” please explain (optional)

How many business locations do you operate? ✶

What year was the building constructed? ✶

Enter 4-digit year

How many stories is the building? ✶

Total square footage of the building ✶

What is the building’s construction type? ✶

General

Business Type

Industry

Website

Operations

Description of Operations

Annual Revenue

Estimated Annual Payroll ($)

Number of Employees

Number of Business Vehicles

Number of Drivers

Coverage Information

Current Insurance Company

Current Policy Expiration

What types of coverage are you interested in?

Commercial Auto

Commercial Liability

Commercial Property

Commercial Umbrella

Cyber Liability

Workers Compensation

Additional Information

Comments

I understand that insurance coverage is not bound or altered until I receive confirmation by an authorized representative of Insurance Network of Louisiana ✶

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Contact Information

Business Information

Coverage Information

Additional Information