Bed & Breakfast to be Insured

Name of business:

Mailing Address 1:

Address 2:

City:

State:

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Zip:

Location Address 1:

Address 2:

City:

State:

  Massachusetts

Zip:

Do you live on the premises?

Yes No

Years operating a Bed & Breakfast?

Meals you serve:

Breakfast
Lunch
Dinner

Is there a swimming pool on the premises?

Yes No

Is there a tennis court on the premises?

Yes No

Is there a fire hydrant within 1000 feet of the premises?

Yes No

Is there a fire station within 5 miles of the premises?

Yes No

Have you had property or liability claims in the past 3 years?

Yes No

What is the construction of the building(s) on your premises?

Frame
Brick
Other

Life Safety?

Yes No

Sprinkler System?

Yes No

Central Station Fire Alarm?

Yes No

Are there hardwired smoke detectors in all rental rooms?

Yes No

Is there a secondary means of egress from all floors?

Yes No

Limits of Insurance:

- Bed & Breakfast Building(s)

- Business & Personal Property

Annual Room Rental Receipts

Person to contact:

Email:

Web Site

Phone Number:

Fax Number

Best time to call:

select day Monday Tuesday Wednesday Thursday Friday Saturday Sunday

select time Morning Afternoon Evening