Kapnick Insurance Group

Golf Course Quick Quote Form

We would like to provide you with a quote for your golf course business. Please provide as much information as possible to help us get this process started. This information will be kept confidential and will be used for quote purposes only.

General Information
 
Legal Name
*
Street
*
City
 *
State
 *
Zip Code
*
Number of Holes
Contact Name
*
Phone #1
*
Phone #2
Fax Number
Email Address
Website Address
 
* Denotes required field
 
Business/Property Information
 
Fire/Security
  
Name of fire department
Miles from department to business
Feet to a hydrant
Name of fire alarm system
Name of burglar alarm system
Seating capacity
Number of stories
Basement

...

 
Cooking
 Deep Fryer.... Grill.... Microwave
check all that apply

Hood duct-auto extinguishing-UL 300

Maintenance contract .... Semi-annual service
 
Check if updated within last 15 years
HVAC .. Electrical .. Plumbing.. Roof
   
Maintenance Equipment Limit
Golf Carts Limit
Building Information
Description
 Building Limit Contents Limit Construction Square Feet Year Built
Clubhouse
Pro Shop
Maintenance Building
Pump House
Halfway House
 
Commercial General Liability
.......Annual Revenues
Golf
Liquor
Food
Pro Shop
 
Payroll
  
Golf Club
Restaurant
Pro Shop
 
Insurance Information
.................Carrier .....................................Premium
Package
Auto
Workers' Compensation
Umbrella
 
Three Year Loss History
Date
Type
Description
Paid/Reserve
Amount
Amount
 
Comments
Thank you for taking the time to fill out this request. When you have completed the form, click on the Submit button below, and a Kapnick Insurance Group representative will contact you shortly. If you would like immediate assistance, contact Julie Gentling at 888.263.4656 x189 or julie.gentling@kapnick.com.
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