One Company, Endless Solutions

The Metropolitan Agency provides Personalized Insurance and Risk Management Solutions in the
New York Tri-State Area.


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Restaurant Insurance Quote Request

Please take a moment to fill out the form below and one of our local insurance agents will contact you with a free, no-obligation quote. This information will be kept confidential and will be used for quote purposes only.

General Information
Your Full Name: *
Middle name:
Date of Birth:
Gender:	Male Female
Marital Status :
Your Company:
Address:
City:
State:
Zip:
County:
Business Phone: *
E-mail Address: *

If living at current address less than two years, provide previous address
Street :
City:
State:
Zip:
County:

Restaurant Location
Restaurant Name:
Address:
City:
State:	Zip:

Current Insurance Information
Company Name: (not agency)
Policy Expiration Date:	Premium Amt: $
Years Insured:
Any Claims Last 3 Years?	Yes No
Liquor Liability Coverage Included?	Yes No
Building Coverage:
Age of Building:
Business Property Amount:
Ansul Type:
Deductible:

Restaurant Information
Restaurant Type:
Catering?	Yes No
Patio?	Yes No
Live Music?	Yes No
DJ?	Yes No
Total Square Footage:
Public Access Sq. Ft.:
Approximate Gross Sales:
Food Sale %:
Alcohol Sale %:
Number of Employees:
Years Insured:

Additional Comments or Questions

	Enter Security Code:

Please click the "Submit Quote Request" button to send your quote request. No coverage is in effect until bound by an insurance carrier. This is a request for quotation only.

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