Insure My Salon - California Salon Insurance Quote - Rick Powell Insurance Agency, LLC

Salon Insurance Quote Form

Please take a moment to fill out this Quick Salon Insurance Quote Form. This information is used for rating only and held in strict confidence.


Beauty Salon Business Insurance Quote		We would like to provide you with a free, no-obligation beauty salon insurance quote. Please provide as much information possible for the most accurate quote. This information will be kept confidential and will be used for quote purposes only.

Business Information
Business Name:
Business Type:
Contact Name:
Address:
City:	State: Zip:
Business Phone:	Fax Number:
Email Address:
Location Address (type "same" if same as above):
City:	State: Zip:

Property Questions
Age of building /Year Built:	Type of building construction:	Number of stories:	Other occupancies:	Square feet you occupy:
				sq. ft.

Coverage Limits
Building:	Contents (equipment, inventory, supplies, etc.):		Deductible:	Loss of Income:
$	$			$
Money and Securities:	Glass or signs:	General Liability Limit:	Non-owned and Hired Automobile Liability:	Professional Liability?
$	$		$	Yes No
Please list other coverages you may need:

Protective Devices
Burglar Alarm:	Central Station or local alarm?:	Name of alarm company:	Is the building sprinklered?:	Are there smoke detectors?:
Y N	Central Station Local Alarm		Y N	Y N

Liability Questions
Please provide information on previous insurance carrier:
Previous Ins. Carrier:	Policy number:	Prior premium:	Policy renewal date:
		$
Please provide information about your business:
Years in business:	Projected Gross annual receipts:		Projected annual payroll:
	$		$
Total Number of Employees:		Total Number of Independent Contractors:
# of Full Time:	# of Part Time:	# of Full Time:	# of Part Time:

Breakdown by primary job duty:
		# of Full Time:	# of Part Time:
Beauticians/Barbers/Cosmetologists:
Nail Techs:
Estheticians:
Massage Therapists (if applicable):
Receptionist/Office Staff:
Are all Operators/Specialists licensed?:			Yes No
Do you employ students?:			Yes No
Do you rent space, booths, or chairs to others?:			Yes No
If yes, how many, and annual income from rentals?:			How Many: Annual Inc: $
Do these independent contractors carry their own liability policies?:			Yes No
Do you manufacture, repackage, or re-label any products?:			Yes No
Do you provide any of the following services? (check all that apply)
Permanent Cosmetic Application		Mole Removal	Tanning Services
Body Massage		Electrolysis	Esthetician Services
Microdermabrasion		Chemical Peels	Plastic Surgery
Diet Advice, Personal Training		Tattooing	Steam Baths/Saunas

Additional Comments

Please give any additional comments you feel appropriate for this quotation. If you have
additional information where there was not enough fields above, please enter them here.

Please be advised that submitting this quote form does not mean that you are receiving
insurance coverage, rather you will receive an estimate of premium that is valid for
30 days and is subject to underwriting review and approval.

Please click on the "Submit Quote" button to send your quote request.
One of our representatives will respond to your submission as soon as possible.

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