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 (Required.)

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2. Last Name (Required.)

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3. Business Name (Required.)

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4. Business Type (Required.)

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

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6. Address 2

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7. City (Required.)

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8. State (Required.)

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9. Zip Code (Required.)

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10. Phone Number (Required.)

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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 (Required.)

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14. Length of time in business (Required.)

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15. Number of employees (Required.)

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16. Website Address

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17. Estimated annual gross receipts (Required.)

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18. Policy effective date

Date

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19. Business Personal Property Amount (Required.)

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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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