Wineries Request for Qoute Part 1
BUSUNESS INFORMATION:
Owners Legal Name:
Winery Name:
Address:
City, State Zipcode:
Year Established:
Federal ID Number:
Contacts Name:
Phone:
Fax:
Email:
Website:
WINE VALUATION
Wine Market Value Endorsment(CP 99 05) desired:
Yes
No
Are the values calculated using market value:
Yes
No
If no what method is used:
Number of types of wine sold:
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
Is Wine Leakage Coverage Desired:
Yes
No
Total storage capacity of wine(gallons):
Deductible coverage desired:
$1000
$2500
$5000
Is there a formal maintenance program for the refrigeration system:
Yes
No
