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Application for Property and Liability Coverage. Please note: This coverage is only available to members of the American Personal Chef Association.

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* 1. First Name

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* 2. Last Name

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* 3. Business Name

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* 4. Business Type

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* 5. Address (no P.O. boxes)

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* 6. Address 2

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* 7. City

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* 8. State

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* 9. Zip Code

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* 10. Phone Number

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* 11. Fax

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* 12. Email Address -

Note: Your quote will be returned to you via email in a word document.

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* 13. Describe your operations

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* 14. Length of time in business

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* 15. Number of employees

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* 16. Website Address

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* 17. Estimated annual gross receipts

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* 18. Policy effective date

Date

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* 19. Business Personal Property Amount

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* 20. Business Personal Property includes equipment you use for your business-pots, pans, utensils, stoves, desks and office equipment. It does not include your car or home.

Number of business owned automobiles

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* 21. Quote an Umbrella Policy?

The umbrella policy is an optional coverage that gives you an additional $1 million of liability protection. It would apply in the case of a catastrophic type of loss where your business owners policy limit of $1 million per occurence is exceeded.

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