Age of building: <1 year 1 - 20 years 20 - 35 years >35 years
Construction of building: Frame Masonry Non-Combustible Fire Resistive
Is the building sprinklered Yes   No

How much area do you occupy? < 5 000 5 000 - 10 000 > 10 000
Are you the only tenant? Yes    No

Is there a hydrant within 500 ft. (150 metres)? Yes    No
Is there a fire hall within 3 miles (5 kms)? Yes    No
Has insurance ever been denied or canceled? Yes    No

What type of business? Retail Office Building ownership Wholesale operation Farm Service Operation Contractor Garage operation Manufacturer Other
How many years in the business? < 1 years 1 - 5 years > 5 years
Have there been any insurance claims in the last 3 years? No <= 2 >= 3
What are the annual receipts? Up to $50 000 $51 000 to $100 000 $101 000 to $500 000 $501 000 to $1 000 000 Over $1 000 000
What is the annual payroll? Up to $50 000 $51 000 to $100 000 $101 000 to $500 000 $501 000 to $1 000 000 Over $1 000 000