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Email Us:
info@newbuffaloinsurance.com
Call Us:
(716) 332-1570
Text Us:
(716) 514-4040
Find Us:
20 E Tupper St Buffalo, New York 14203
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Current Insurance Policies
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Workers Comp / DBL – PFL
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Email:
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Physical Address:
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Address Line 2
City
Alabama
Alaska
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Delaware
District of Columbia
Florida
Georgia
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Hawaii
Idaho
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Washington
West Virginia
Wisconsin
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Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
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ZIP Code
Website Address:
Requested Effective Date:
MM slash DD slash YYYY
Are You A Contractor?
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No
Year Business Started:
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Number of Employees:
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Estimated Annual Payroll:
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Estimated Annual Revenue:
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Please confirm that there is no cannabis related business for the named insured or possible tenants
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There is no cannabis-related business related to this named insured or any tenants
The named insured does operate in cannabis-related business or at least one tenant has a cannabis-related operation
Brief Description of Operations:
Additional helpful information:
Additional Contractor Details
% of work Subcontracted out
% of Residential Work
% of Commercial Work
% of Remodel/Install work
% of New Construction Work
% of Service/Maintenance Work
Do you perform Government/Municipality Work?
Yes
No
Do you need a policy to fulfill a certificate of insurance requirement?
Yes
No
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