Bars & Clubs

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Louisiana • Mississippi • Florida
Business Info
Business Name:
Your Name:
Address:
Phone Number:
E-mail:
Current Carrier:
Building Coverage Amount:
Content Coverage Amount:
Number of Owners:
Years in Business:
Had a loss in the last 3 years?  Yes No
Requesting property coverage?  Yes No
Limits of Liability:
Property Info
Alarm System?  Yes No
Square Footage:
Age of Building:
Building Construction Type:
Roof Type:
Video Game Devices:  Yes No  
Pool Tables:  Yes No Qty/Type:
Hours of Operation:
Estimated Food Sales:
Estimated Liquor Sales:
Business Income Amount:
Current Policy's Expiration:
Comments:
Your company information will be used for insurance quoting only and not sold for any other purpose. Thank you for letting us quote your insurance needs.


Southern Insurance Agency, LLC

725 Magazine Street, Suite E
New Orleans LA, 70130
Telephone: 504.528.9242
Toll Free: 855.528.9242
FAX: 504.528.9245
E-mail:  lfaust@siallc.com

  
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