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Your Name* Business name* Email* Phone* Salon Address* City* State* Zip code* Effective date requested What type of business do you have?* ProprietorshipLLCCorporationPartnership Website or Facebook page* Current insurance carrier Gross sales over the last 12 months* Number of UV tanning units Number of spray tanning units Number of independent contractors Other services Property value of salon What type of building are you in? Free standingStrip mallResidentialEnclosed mall Do you have a central burglar alarm? YesNo Do you have an operational sprinkler system? YesNo What type of construction is the frame of the building made out of? (wood, brick, block, steel?) WoodBrickBlockSteel What year was the building built? How many stories tall is the building? Is there a basement? YesNo How many square feet do you lease or own? If the building is 25 years or older, what year were improvements done to the roofing, plumbing, heating and electrical? Is your local fire service full or part time? FullPart-time Are you located in the city limits? YesNo Are you responsible for covering any tenant improvements such as HVAC, walls, flooring? If so, what $ amount of your business personal property should be designated for tenant improvements? How many years experience do you have managing a tanning salon?* 0123+ Are you tanning certified?* YesNo Have you had any liability claims in the last five years? Have you had any property claims in the past 5 years? Are you interested in worker's compensation insurance? YesNo Anything else?