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Lighthouse Santa Cruz

CREATING PEACE OF MIND
SINCE 1964

Commercial Property Insurance Questionnaire

Business Information

Building and Property Information (if applicable):

Is the building Sprinklered?
Yes
No
Does the building have an alarm?
Yes
No
Is the building monitored?
Yes
No
Does the building have a fire alarm?
Yes
No

Updates: IMPORTANT

**If building is 20 years or older, please complete form Older Building Supplemental (below).

Coverage Requested

Building Ordinance:
Yes
No
Flood:
Yes
No
Earthquake:
Yes
No
Limit:
$1 million
$2 million
$3 million
Other
Umbrella/Excess Liability Coverage:
Yes
No

*Please note: if you leave this page before hitting submit, your form may not be saved.

Is the building more than 20 years old? If so, please complete the additional form.

Interested in other coverage options or a package discount?

Earthquake Insurance
Flood Insurance
Personal Umbrella Protection
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