One Company, Endless Solutions

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


Share \|

Wholesalers & Distributors 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: *
Company Name:
Address:
City:
State:	Zip:
Business Phone: *
E-mail Address: *

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

About Your Business
Number of Employees:	Years in Business:
Number of Locations:	Annual Sales:	$
Detailed Description of your Business:

Current Insurance Information
Company Name: (not agency)
Policy Expiration Date:	Premium Amt: $
Years Insured:
Any Claims Last 3 Years?	Yes No

Building Information
Year Building Built:
Number of Stories:
Building Square footage:
Occupancy:	Owner Tenant
Square Feet Occupied as Owner or Tenant:
Automated Sprinkler:	Yes No
Replacement Value of Building:	$

Operations and Sales Information
Manufacturing Product:
Materials Requiring Special Storage Practices:	Yes No
Any Retail Operations:	Yes No
Percent of Annual Sales Retail:
Percent of Annual Sales Wholesale:
Retail Operation Location:

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.

Designed & Developed by WillShalll