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


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Computer Information Technology (IT) Insurance Quote Online Request

General Information
Your Full Name: *	*
Your Company: *	*
Address: *	*
City: *
State: *	* Zip: * *
Federal Tax ID Number:
Business Phone: *	* Fax:
Entity Type:
E-mail Address: *	*Invalid format.
Your Business Website Address:

Current Insurance Information
Company Name: (not agency)
Policy Expiration Date:
Premium Amount: $
Years Insured:

Amount of General Liability Coverage Needed
$500,000	$2,000,000
$1,000,000	$5,000,000

Property Questions
Do you own your Building?	Yes No	Building Replacement Value:	$
		Replacement Value of Contents:	$
Do you have Company Vehicles?	Yes No	If Yes, How many?
Square Footage Your Business Occupies:		Number of Stories:
Exterior Walls:		Basement:

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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