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Business Name
Contact Name:
Business / Location Address:
City:
State:
IL
MO
KS
ZIP:
Address Type:
Individual
Corporation
LLC
Proposed Effective Date:
Building Coverage Limit:
Liability Limit:
300,000
500,000
1,000,000
2,000,000
Building Property Limit:
Year Building Was Built:
Square Feet of Property
Please describe build type:
Brick
Frame
Estimated Annual Revenue:
Worker's Comp
Annual Payroll
How Many Employees
Contact Phone Number:
Contact Email Number:
Description of Business Operations:
The Firm Insurance Group, Inc.
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Phone:
1-800-258-6430
Email:
team@thefirminsurance.com
