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James Cantwell
Paul Coupin
Michael Crist
Robert Crist
Marc Dronkers
Jack Fritschi
Jeff Fritschi
Tom Paterson
Tom Smith
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PROPERTY AND LIABILITY
Proposed effective date
Name of business
Contact person
Phone number
(
)
Email address
* Required
Mailing address
Property address, if different
Number of locations
Year business started
Entity type
Individual
Partnership
Corporation
Joint Venture
S-Corp
Not For Profit
LLC
Brief description of operations
Any owned autos
YES
NO
Number of employees
Estimated annual sales
Building owner or tenant
OWNER
TENANT
Square footage occupied
Building construction type
WOOD FRAME
CONCRETE
CONCRETE BLOCK
STEEL
Number of stories
Year building built
Year of major updates
A. Wiring:
B. Plumbing:
C: Roof:
D. Heating:
Burglar alarm
YES
NO
If yes, central station?
YES
NO
Central station fire alarm
YES
NO
Fire sprinklers
YES
NO
Requested Building Limits
Requested Personal Property limits
Requested Deductible
CF&P insurance | P.O. Box 1979 | Oakland, CA 94604 | OFFICE PHONE (510) 433-4200
