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Our Business Insurance Carriers

• MetLife
• Safeco
• Zurich
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• Philadelphia Insurance Co.


Arizona Business Insurance Application

Pritchard Group Insurance makes shopping for business insurance easy. Fill out our short, easy form and we'll shop for those companies who will compete for your business and find you the best deal. Get started now.

Business Name: *
Owner / Contact: *
Street Address / Suite: *
City / State / ZIP: *
Phone (please include area code): *
Email: *
Type of Organization:
Number of Full Time Employees:
Number of Part Time Employees:
Type of Business:
Hours of Operation:
Years in Business:
Gross Sales - $ Yearly Payroll Excluding Owners - $

General Liability Information

Will this replace an existing business policy? YES NO
Current Carrier
When will your current policy expire?
Liability Limit:
Losses in last 3 Years - $
Current Yearly Premium - $
Has your coverage ever been canceled? YES NO

Property & Contents Information

Is your building ... LEASED OWNED
Name of Landlord / Mortgage Holder:
Burglar Alarm? YES NO
Sprinklers? YES NO
Fire Alarm? YES NO
Year Built:
Type of Construction
Business Personal property Limit - $
Business Personal Property Deductible - $
Contents Value - $
Value of fixtures and Displays (not part of building) - $