Step 1 of 5

Type of Insurance Interest
Federal ID# or SS#
Business Name
Year Business Started
Legal Entity/Status
Scope of Business
Owners of Business
Do you own the building
Is the building owner to be name as additional insured?
Number of years in business
Gross Annual Payroll
Gross Annual Revenue
Number of full-time employees
Number of part-time employees
Website
Landline Telephone
Have their been any claims over the last 5 years?
Are employee hiring procedures in place on application and employment manual for background checks, confidentiality agreement & non-piracy agreement?
Fred Meyer & Sons
Fred Meyer and Sons, Inc. | 7200 North Point Road | Baltimore, MD 21219 | 410-477-0900

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