"Garage Insurance"
 
  Business Name      
  Contact Name      
  Address   City
  State       zip
  Phone       Fax
  Email      
  Number of Employee   Year in Business  
  Prior Coverage            
  Prior Insurance Company      
  Policy Number        
  Employee Name   DOB   DL#   Driver (Y/N)
 
  Building            
  Building Construction   Contents
  Monitor Burglar Alarm     Building Sqft
  Limits of Liability   Sign Coverage
  Garage Protection    Garage Keeper
  Comment