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RIGHTSURE Wins
Agent for the Future Award
from Liberty Mutual Insurance
520-917-5295
520-917-5295
info [at] rightsure [dot] com
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MITA/CARMA Quick Quote Form: Dispensary/Retail
Business Name:
Business Address:
Phone Number:
Email:
Owner/Applicant Name:
Liability Type (check all that apply):
General Liability
Product Liability
Property
Excess Liability
Are you a new Venture?
Y
N
Are you Licensed?
Y
N
Year Established:
Business FEIN:
Do you currently have insurance?
Y
N
Policy Effective Date:
Annual Sales:
Property Details
Property:
Own
Rent
Construction Type (check all that apply):
Frame
Jointed Masonry
Non-Combustible
Masonry Non-Combustible
Fire Resistive
Building Amount:
TIB:
Equipment:
BI:
Finished Stock:
Additional Comments:
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