Professional Cleaning Services Program

Professional Cleaning – Commercial

  • General Information

  • Date Format: MM slash DD slash YYYY
  • Date Format: MM slash DD slash YYYY
  • * PLEASE ATTACH COPIES OF YOUR CURRENT POLICY DECLARATIONS PAGES FOR MOST ACCURATE QUOTE *
  • Policy Limits | PROPERTY

  • ► Contents may include, but is not limited to: Leasehold Improvements, Leased Property, Inventory, Furniture/Fixtures, Equipment, Printed Materials, Consumables, and Property of Others in Your Care. Please consult your lease requirements when choosing the coverage and limits for this location.
  • Policy Limits | CRIME

  • Policy Limits | GENERAL LIABILITY

  • WORKERS COMPENSATION | OWNERS | List below all owners of the business, whether active or inactive.


  • WORKERS COMPENSATION | List below payroll for all employees EXCEPT OWNERS

  • Janitorial Services – Labor

  • Office – Inside

  • Sales – Outside

  • Policy Limits – AUTOMOBILE

  • Policy Limits – UMBRELLA

  • PROPERTY – Underwriting Questions

  • GENERAL LIABILITY – Underwriting Questions

  • AUTOMOBILE – Underwriting Questions

  • WORKERS COMPENSATION – Underwriting Questions

  • UMBRELLA – Underwriting Questions

  • VEHICLE SCHEDULE – Please complete the below or attach a separate schedule of your own


  • DRIVER SCHEDULE – Please complete the below or attach a separate schedule of your own

  • Date Format: MM slash DD slash YYYY

  • GENERAL UNDERWRITING QUESTIONS

  • OTHER COVERAGE TO CONSIDER – Please type any comments or requests below

  • PLEASE CONTACT YOUR CURRENT AGENT OR INSURANCE COMPANY FOR A CURRENTLY‐VALUED LISTING OF YOUR CLAIMS HISTORY (“LOSS RUNS”) FOR THE PAST 3 YEARS.