Fred Meyer and Sons

*Step 2 of 6*
*Coverage Selection:*
*Common Coverage Types (select at least one)*
General Liability (Protects the assets of a business in case of a lawsuit related to injury or property damage.) Business Owners Policy (Combines general liability and business property coverage into a single policy.) Commercial Auto (Provides coverage for business-use vehicles. Can range from one car to an entire fleet.) Workers Compensation (Protects employers from lawsuits resulting from workplace accidents. Also provides medical care and lost income compensation to employees injured on the job.) Group Health (Provides health benefits to a business's employees.)
*Additional Coverage Types (select at least one)*
General Liability (Protects the assets of a business in case of a lawsuit related to injury or property damage.) Business Owners Policy (Combines general liability and business property coverage into a single policy.) Commercial Auto (Provides coverage for business-use vehicles. Can range from one car to an entire fleet.) Workers Compensation (Protects employers from lawsuits resulting from workplace accidents. Also provides medical care and lost income compensation to employees injured on the job.) Group Health (Provides health benefits to a business's employees.)

*Step 3 of 6*
*Business Information*
*Contact's First Name*
*Contact's Last Name*
*Contact's Address*
*Suite or Unit #*
*City, State, Zip*
*Legal Entity/Status*
*Number of year in business*
*Gross Annual Payroll*
*Gross Annual Revenue*
*Years of Owner Experience within Industry*
*Brief description of the business*

*Step 4 of 6*
*Business Information*
*Average Hourly Wage*	$
*Desired Deductible*
*Time that business opens*
*Would you like company officers excluded from this coverage?*	Yes No
*Do you have a safety program?*	Yes No

*Step 5 of 6*
*Business Information*
*Business Street Address*
*Business Suite/Unit #*
*City, State, Zip*
*Year Built or Last Updates Completed*
*Construction type*
*Number of Stories*
*Total Square Footage of Building*
*Square Footage of Space Occupied by this Business*
*Burglar Alarm Type*
*Fire Alarm Type*
*Physical Building Coverage Limit*	$
*Business Personal Property Amount*	$
*Additional Properties to Insure?*	Yes No
*Select Additional Coverage Types to Discuss with the Agent*	Non-owned Auto Coverage Employment Practices Liability Coverage