HOTELS / MOTELS QUOTE FORM (Acord 125)

First Name: *

Last Name: *

Email Address: *

What is the name of your corporation:
What is your DBA: Open the calendar popup. << < April 2025 > >>   S M T W T F S 14 30 31 1 2 3 4 5 15 6 7 8 9 10 11 12 16 13 14 15 16 17 18 19 17 20 21 22 23 24 25 26 18 27 28 29 30 1 2 3 19 4 5 6 7 8 9 10
What is your location address:
City:	State:	Zip Code:

What is your Home Phone Number:	Cell Number:
What is your Work Phone Number:	Fax Number:
Is your Business a hotel or motel:

PROPERTY (Acord 140)

How much building coverage do you need:
How much contents coverage do you need:
Total square footage of each building:
Square footage of each room:
Do you have Central Station Alarm : Yes No Sprinkler System: Yes No
What is your building construction type:
What year was it built:	What is your occupancy rate:
Average room rate :	Sign:$
--Acord 125--------------------------------------------------------------------------------------
Do you have a manager room: Yes No A restaurant: Yes No (Cooking): Yes No Sell Liquor: Yes No Have a pool: Yes No Fenced Pool : Yes No
How many buildings:	Number of floors:
Number of rooms:
Do you have federal ID available:
Who is your current insurance company:
Expiration date: Open the calendar popup. << < April 2025 > >>   S M T W T F S 14 30 31 1 2 3 4 5 15 6 7 8 9 10 11 12 16 13 14 15 16 17 18 19 17 20 21 22 23 24 25 26 18 27 28 29 30 1 2 3 19 4 5 6 7 8 9 10	Current premium: $
Do you have claim or losses:
(Only if this business has or has had Insurance, request 3-year loss runs)
Say: "Please fax us your 3-year loss history"

LIABILITY (Acord 126)

How much liability coverage do you need:	$
What are your annual gross sales :	$
NOTES