PnCguru

State*

Inventory*

Select Industry *

When do you need your insurance to begin/renew?

General Liability Limit

First Name*

Last Name*

Email Address*

What is your Primary phone number

How's Your Business Registered?

What is your business’ name?

Federal Employer ID Number (FEIN)

If you are doing business under a different name, please enter it here.

What year did you start your business?

How many years of management experience do you have in this field?

Does your business have a website?* Yes No

What is the total annual sales for your business?

Annual payroll (exclude owner(s) and subcontractors)

Annual owner payroll

How many employees do you have,including part time employees (Do not include yourself, partners and officers)?

How many vehicles are registered under your business name?

Is your business open 24 hours a day?* Yes No

To protect your business's electronic data,do you use firewalls and anti-virus software,back up data frequently, and physically secure equipment that holds Electronic Data?* Yes No

Does your business use rented or non-owned vehicles (e.g. an employee's car) for business purposes?* Yes No

Address Line 1*

Address Line 2

City*

State*

Zip Code*

Please select the insurance company currently providing coverage for your general liability and business property.

Does your business perform any design, construction, installation, removal, or physical repair of any property or tangible good?* Yes No

Does your business provide any of the following operations, goods, or services:* Yes No

* Auto, boat, or utility vehicle parts and dealers
* Convenience stores
* Department stores
* Farming or gardening supply stores
* Auto repair or gas stations
* Health food, vitamin, or drug stores
* Grocery stores
* Pet or pet supply stores
* Restaurants, bars, or nightclubs
* 100% of revenue derived from e-commerce or internet sales
* Alcohol, tobacco, electronic cigarette, or vapor stores
* Gun, firearm, or ammunition stores

What are your business's estimated gross sales during the next 12 months?*

Do you have any losses?* Yes No

Do you or your business supply, manufacture, or distribute any tangible goods or products?* Yes No

Have you ever been declined orhad your insurance coverage canceled or non-renewed in the past 3 years?* Yes No

I agree to the PnCguru Terms and conditions and Privacy Policy

Insurance information

Primary Insured information

Business information

Mailing Address

Insurance information*

Location Address

Occupancy Information

Location Address

Occupancy Information

User Information

Insurance information

Primary Insured information

Business information

Mailing Address

Insurance information*

Location Address

Occupancy Information

Location Address

Occupancy Information

User Information

Insurance information

Primary Insured information

Business information

Mailing Address

Operator

Operator

Vehicle Details

Insurance Information

Vehicle

Garaging address

Vehicle

Garaging address

Auto Coverages Details

General coverages

TX State Specific coverages

Vehicle coverages

Vehicle coverages

User Information

Insurance information

Primary Insured information

Business information

Mailing Address

Location Details

Insurance Information

Location

Address

Occupancy Information

Building Information

Location

Address

Occupancy Information

Building Information

Employee Information

Insurance Information

Employee Information

Insurance Information

Additional details

User Information

Insurance information

Primary Insured information

Primary Insured information

Business information

Mailing Address

Location Details

Insurance Information

Location

Address

Location

Address

E&O Details

Your Business

User Information

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