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To Get A Quick-Quote Complete The Below Underwriting & Rating Information Form




Please fill out as much information as possible.

If you have any questions regarding this form please contact us.

    Business Owners Insurance Policy Quote Request

(* Indicates a required field)

All information provided will be regarded as strictly confidential, and will be used only to secure an accurate quotation for insurance coverage.

Named Insured:

General Information:

* Business Name   

Type of Business :

*Contract - Full Name:

Describe Operations :

  * Title / Position:   Business Model:  
 * Employers Federal Tax Id # (FEIN) 

 Select Any Other Kinds Of  Coverage That You Want Us To  Quote:

*Contact Phone:

 Cell # 

Business Owners Policy     : Package Policy That Combines

Building / Contents / Liability

Into A Single Policy


Flood Insurance :                     

Workers Comp:                           Fidelity/Surety Bond                      


   Commercial Auto:                                Cargo /  Freight:( Inland/Ocean Marine)  Heavy Equipment                                               

Web Site Address:


Umbrella Liability:                        Professional Liability :

Other - Please specify or describe:



*Send QuickQuote By : Email Fax Both



Current Insurance Carriers Name :  

Policy Number

Expiration Date:  

OccurrenceClaims Made

If Claim Made Provide Retroactive Date:

Please send copy to : or Fax (936) 448-1013

 *Business Address:          



 State: Zip :


Mailing Address:          Same as Mailing Address

City :

State:    Zip: 

County : 


Business Information:


Years in Business:

Total #   Employees:  

Employees :  # Full Time:  # Part Time:

 Approx. Annual Gross Sales / Revenue $

Approx. Annual Payroll $


Business Owners , Partners ,or Officers

Premium Calculation Wage Limitations Applies To

 Wages Included In Premium Calculation For ARTISAN Contractors

Provide Name Of Individual Owner or Partners

$31,900- FLAT Annual Payroll (effective 12.01.84).

Automatically covered. 

Provide Name Of LLC Members

$31,900- FLAT Annual Payroll (effective 12.01.84).

Automatically covered. 



Provide Name Of Corporate Each Officer:

$31,900- FLAT Annual Payroll (effective 12.01.84).

Automatically covered. 



Property Coverage Limits Requested:Need help with selecting coverage limits or understanding coverages offered call 1-800-361-8734 !

*Replacement Cost Coverage Building (Structure)                                Business Personal Property (Contents)

       *Requested Effective Date:

* Building Coverage Limit $  *Business (Contents) Personal Property     Limit $
*Deductible $ *Wind/Hail Deductible$

 Property of Others $

  Computer Equipment $

 Mechanical Breakdown (Ac/Heater/Boiler)    Computer Software $
Off Premises Coverage $

Building Glass $

Business Interruption Coverage $

 Extra Expense Coverage $

 Sign Coverage $

Money & Securities Coverage $

       Ordinance or Law Coverage $

 Accounts Receivable Coverage $

Spoilage Coverage     $  (Perishable goods)

Valuable Papers Coverage $

   Utility Services - Direct Damage $

     Utility Services  - Time Element Coverage  $

Backup of Sewer $

 Employee Benefit Plan Fidelity Coverage $

General Liability Coverage Limits Requested:  Need help with selecting coverage limits or understanding coverages offered call 1-800-361-8734 !      Select Policy Type:  Occurrence Claims Made

 *General Liability Limit $

Per OccurrenceComb.Single Limit

Limit Per Each Occurrence

Aggregate Limit All Claims

Product or Complete Operations Coverage $

 * Medical Expense (No Fault) $

 Personal & Advertising Injury $


* Deductible $

Per Claim Per Occurrence

 Employee Benefits Liability $

 *Fire Legal Liability $

 Garage keeps Coverage $

 Host Liquor or Liquor Liability $

   Hired or Non-Owned Auto Liability $

Does you business currently have Professional Liability Insurance Coverage?YesNo    

If " Yes" Provide Insurers Name   Policy #     Effective Date


Location / Occupancy Information: Need help with completeing the rating information section call 1-800-361-8734 !


Year Built  % Of Bldg .Occupied Square Feet For Bldg or Office    
Owner Tenant Check Here If You Have More Than 1 Location

We will be contacting you by telephone or email to get additional location information

Location            Click To View

Building Construction Type

Year      Building      Constructed Number Stories Distance To                                         Fire Hydrant Distance To                Fire Station Inside City Limits

Fire Alarm Type

Does the business        have a Fire Alarm Certificate? Number Of  Employees At This Location    Ownership - Mortgaged ?

Annual Rental Revenues                     (If applicable)

YeNo $  
Does anyone permanently reside at any location ? YeNo If "Yes" List Locations  

Burglar Alarm Type

Does the business        have a Burglar        Alarm Certificate? Number Of Basement Levels

Does building have fire sprinklers?

If sprinklers what % of building has sprinklers?

Square Footage Occupied By Your Business

Yes No Yes No % Sq Ft
Normal number of hours per day your business operations  
Location  Indicate by  checking the appropriate box below if any of the safety/security measures listed have been implemented :
Exterior Light Front/Back Exterior Doors 2Cylinder Dead-Bolt Doors Wire Mesh/Bars Guard DogGuardVideoSmoke DetectorHoldup AlarmSafe

 What is the maximum amount of cash money left at any location overnight ?  $ 


  Loss History Information:

Our Insurance Company Underwriters May Require Prior Carrier Generated Loss History Reports For Last 5 Years Prior To Binding Coverage.


 *Has your business had any losses or filed a workers compensation claim in the last five years? YesNo


If "Yes" Please Briefly Provide Details ( amount paid / carrier / policy # /  date of injury / nature of accident / injury sustained) or

Send Us Your Prior Insurers Valued Loss Runs For The Past 5 Years to: or fax (936) 448-1013.


         Additional Comments/Remarks You Wish Us To Consider While Preparing Your Quote:

Submission of quote request form to Hemphill Insurance Agency does not constitute a binding confirmation of new or revised insurance coverage.  To confirm binding or current policy revisions you must receive a written confirmation for any  new or change in coverage from our agency staff.


Submitting Agent/ Producer  - Name: Tel: Email:






ACORD FILLABLE APPLICATIONS (These Are  Insurance Industry Standardized Underwriting Forms Accepted By Virtually All Carriers )





Fillable Click



Commercial General Insurance Application

  PDF Fillable



Commercial General Liability Section

  PDF Fillable



Commercial Property Section



Download All Application Forms To Your System - Complete Each Applicable Fillable Application - Print

 Send To : Email or Fax (936) 448-1013


 Business Owners Insurance Policy

Insurance Service Office (ISO) SAMPLE Policy Forms

Note: These Are Sample Policy Forms That Represent Insurance Industry Standardized Commercial Lines Policies.

Coverage proposals presented to you by our Agency may differ; as each insurer represented may offer modified coverage by endorsement or have filed it's own unique policy forms with the Texas Department Of Insurance. Please carefully read any carrier prepared proposal presented to you and where necessary request a copy of each insurance company policy and/or endorsement form presented; so that you may compare any differences in coverage offered.


    BusinessOwners Policy Form - ISO - BP 00 01 12 92 - Standard Property Form  (click to view / read / print )

BusinessOwners Policy Form - ISO- BP 00  02 12 99 - Special Property Form  (click to view / read / print )

BusinessOwners General Liability  Coverage Form  BP 00 06 01 97 (click to view / read / print )


Package policies that combine property / general liability insurance coverages for commercial buildings / contents / loss of income with several other kinds of coverage into a single multi-peril insurance policy .


Businessowners Insurance  Policies help businesses, including farms and ranches, pay to repair or replace buildings, associated structures, and contents damaged by fire, storms, theft, and other events outlined in the policy.

This publication provides general information about the kinds of commercial property coverage that are available in Texas. It can help you evaluate different commercial property policies, understand how rates are determined, and ask the right questions when shopping for insurance. You should review your policy carefully to understand your specific coverage.


Business owners who either own or lease their buildings may purchase commercial property insurance. It’s important for a tenant business to understand that the building owner’s insurance policy will generally only cover the building or structure, not the contents of the building belonging to the tenant. Tenants should purchase their own policies to insure their on-premises property, such as machinery, furniture, and merchandise. An insurance company will evaluate factors such as a structure’s location and construction materials to determine the likelihood of a property loss. The cost of tenant coverage will generally be significantly less than for owned property coverage because the policy will only apply to the leaseholder’s on-premises property and not the building.

Typically, businesses operating on multiple premises are covered by a single policy. In certain instances, such as when two business locations serve different functions and have different risk profiles, separate policies may be needed. This may be the case when a business insures both an office location and a factory, for example.

A commercial property policy may pay based on either the “actual cash value” or “replacement value” of a loss. An actual cash value policy will pay only the amount of the property’s worth at the time of the loss  Worth is determined by the value of the property minus depreciation due to age and normal wear and tear. A replacement value policy will pay to purchase new property of like kind and quality after a loss. In general, a replacement value policy better ensures that a business can fully recover after a significant loss. Replacement value policies are typically more expensive than actual cash value coverage because the policy limits should reflect the cost to replace damaged property with new property.

Almost all policies have a “deductible,” which is an amount the business must pay out of pocket toward the cost of a claim before the insurance company will pay. Generally, the higher a policy’s deductible, the lower its premium will be because the policyholder is accepting a greater share of the cost of any eventual claims. Most policies will also include a “policy limit,” which is a maximum amount the insurer will pay toward any covered loss.

Insurers use a process called “underwriting” to evaluate the likelihood that a given policyholder will file a claim for a loss. The greater the likelihood, the higher the premium will be. If an insurer determines that a business poses too great a risk of a loss, it may decline to issue a policy entirely. If your business is declined for coverage, keep shopping; companies have their own criteria for determining whether to issue coverage and the rate to charge. If one company turns you down or is too expensive, another may be willing to issue coverage or offer a lower premium. There may also be certain steps your business can take to lower its risk and either qualify for coverage or get a lower rate.

Different types of commercial property policies protect against different risks, or “perils.” It’s important to understand which types of losses a policy does and does not cover. A commercial property policy will almost never cover any loss that is either not specifically included in the policy language or is specifically excluded. Therefore, be sure you read a policy carefully before you purchase it. You may need to buy certain specialized policies, such as flood, windstorm, or crime coverage to be protected from those particular losses.

Commercial property insurance is not standardized in Texas. Insurance companies must comply with minimum requirements but have a great deal of flexibility to develop their own policies.  As a result, the coverage provided by one insurer’s policy may differ substantially from that of another. When shopping for commercial property insurance, be sure to evaluate the costs and coverages of the policies you’re considering.

Common Commercial Property Coverages

Commercial property policies in Texas generally fall into one of three categories:

  • Standard form policies typically cover common risks or perils, such as damage caused by fire, lightning, vehicles, aircraft, or civil commotion. Most basic form policies also cover damage from windstorms, except in counties on the Texas coast, where businesses will likely need to purchase a separate policy for windstorm protection.
  • Broad form policies typically provide basic form coverage plus coverage for additional perils, such as water damage, structural collapse, sprinkler leakage, and losses resulting from ice, sleet, or weight of snow.
  • Special form policies cover against all types of losses except those specifically excluded by the policy. Common special form exclusions include losses resulting from flood, earth movement, war, terrorism, nuclear disaster, wear and tear, and insects and vermin.

Additional coverages

Many business owners buy additional coverages. Some are available as separate policies, and others are available as endorsements, or “riders,” that enhance or amend a policy’s base coverage. Generally, adding endorsements to a policy will increase your premium. Ask your agent about these additional coverages:

  • Liability insurance. Protects against the cost of lawsuits and possible court judgments.
  • Business interruption coverage. Pays for actual or projected income lost when a covered peril prevents normal business operations. Coverage forms can be added to a commercial property policy that provide only business income coverage, only extra expense coverage, or a combination of both in the same form.
  • Extra expense coverage. Pays any added costs a business may incur resulting from the need to expedite the return to operations after a covered loss.
  • Building occupied by the insured. Covers a building that the insured regularly uses but does not own. This endorsement can be important if a business leases or borrows a building that’s critical for operations.
  • Newly acquired or constructed buildings. Most commercial property policies allow the insured to add newly acquired property to their policies within a certain time period. If the insurance company is not notified within the time period, typically 30 days, the coverage will not apply. Commercial property policies generally only cover buildings named in the policy.
  • Property off premises. Property located within a covered structure is generally covered by a base policy. Damage to property located off premises may not be covered, or may only be covered to a limited extent. Coverage for off-premises property can often be purchased as an endorsement to the base policy or as a stand-alone policy.
  • Personal property of employees while at insured premises. Generally only property owned by the insured entity is covered, unless this endorsement is added. A coverage extension in the base policy might provide a limited amount of coverage for personal effects and property of others.
  • Valuable papers coverage. Assigns a value to records or other essential information that could be lost. Papers are typically covered only to a limited extent by the base policy.
  • Ordinance or law coverage. Provides an additional amount to cover the increased cost of construction necessary to comply with building codes that might be triggered after a covered loss damages the insured property. This coverage can be added by endorsement, but the base policy might contain a limited benefit.
  • Boiler and machinery coverage. Boilers, air conditioning units, compressors, steam cookers, and electric water heaters are examples of machinery typically covered by this endorsement. Coverage generally extends to specifically listed machinery and any subsequent losses that result, such as when a boiler explosion or water heater leak causes damage to other property. This coverage may also often be purchased as a separate stand-alone policy.

Coverage against Crime

There are several types of policies that can protect a business from losses resulting from crime. Policies may be issued on a “loss sustained” or “discovery” basis. Loss sustained coverage pays for losses that occur during the policy period, while discovery coverage pays for losses that occur at any time. Both types require that losses be discovered during the policy period or extended reporting period. Common crime coverages include:

  • Loss of glass and money due to theft pays for damage to glass and any loss of money resulting from a break-in.
  • Robbery and safe burglary, property other than money is a more limited form of coverage that does not include money or securities.
  • Forgery or alteration protects a business against forgery or alteration of checks, drafts, promissory notes, or other directions to pay.
  • Theft, disappearance, and destruction coverage insures money, securities, and other property against loss, both on premises or in the custody of an employee or messenger while off premises.

Commercial Multi-Peril Policies

Commercial multi-peril (CMP) policies combine one or more coverage forms, such as commercial property, general liability, inland marine, crime, or commercial auto, in a single policy. A business owner could add other types of coverage to ensure full protection within the convenience of a single policy.

Business owner programs (BOPS) are a common form of commercial multi-peril policy. BOP policies are tailored to the needs of small-business owners and combine property and liability coverage in one policy.

Flood insurance

Some companies may include flood coverage in their commercial property policies for areas with a low flood risk. However, most flood insurance in the United States is administered by the National Flood Insurance Program (NFIP).

To qualify for NFIP coverage, a business must be located within an NFIP-participating community. These communities have adopted federal building and floodplain management programs aimed at reducing the likelihood of future flood damage. “Special Flood Hazard Areas” are high-risk areas within NFIP communities that are a more likely flood risk. The NFIP requires all structures within these areas to have flood insurance. Because 25 percent of all floods occur in areas designated as low-to-moderate risk, even businesses outside hazard areas could benefit from flood policies.

Flood insurance is purchased through designated private insurance agents.. To get a quick quote click here call 1-800-361-8734.

Windstorm and Hail insurance along the Texas coast

Insurance companies usually exclude windstorm protection from commercial property policies for businesses located in one of Texas’ 14 coastal counties or within certain areas of Harris County. Property owners in these areas will have to buy windstorm coverage through the Texas Windstorm Insurance Association (TWIA).

TWIA is a “pool” of all property and casualty insurance companies authorized to write coverage in Texas. The insurers share the claims risk for structures located in areas with a high risk of windstorms. Buildings in these areas constructed, repaired, or remodeled prior to January 1, 1988, are automatically eligible for TWIA coverage. Those constructed, repaired, or remodeled after that date are required to pass a state inspection and receive a Certificate of Compliance, Form WPI-8, before windstorm and hail insurance coverage can be issued through TWIA.

If a business notifies its local Windstorm Inspection Field Office before beginning construction or repairs, a TDI inspector may be able to perform the inspection free of charge. The inspection will be scheduled for sometime during the course of the work. If the business requests a windstorm inspection after construction or repair work has started, the inspection must be performed, for a fee, by a Texas-licensed professional engineer approved by the Commissioner of Insurance. A list of professional engineers approved to do windstorm inspections is available on the TDI website and is also available at local TDI Windstorm Inspection Field Offices.

How Commercial Property Rates are Determined

Fire risk is typically the primary factor that determines a policy’s premium. Accordingly, a business with neat, orderly grounds and good fire protection will likely have a lower premium than a business with debris piled next to buildings and little or no fire protection. The type of business also is an important factor. For example, an explosives factory would almost certainly be deemed a higher fire risk than a travel agency.

Fire risk is assessed according to a formula to determine the structure’s “fire rating.” The complex formula weighs many factors to determine the fire rating, which largely determines the property’s premium rate.

The fire rating is determined through a physical inspection of the property by a state-licensed fire inspector. Fire inspectors are typically contracted by insurance companies to perform inspections as part of the underwriting process. Inspectors are required to use a standard rating system to determine fire ratings. The five criteria used are:

  • Construction materials. Buildings made of potentially combustible construction materials will likely have higher premiums, while those made of fire-resistant materials could earn a discount. Additions to an existing structure may negatively impact a fire rating, so it’s a good idea to consult with your agent or insurer before remodeling. Internal structural elements can also impact a fire rating. Using wood partitions, floors, and stairways in an otherwise fire-resistant building will likely nullify any rate reduction, whereas fire-resistant interior walls, floors, and doors can help preserve a good fire rating.
  • Location. Buildings located in cities or towns with good fire protection , as assessed by the Texas Commission on Fire Protection, typically cost less to insure than buildings outside of a city, where fire protection may be limited.
  • Occupancy. The nature of a building’s use also impacts its fire rating. An office facility will likely rate favorably, provided that it contains little equipment that could start or feed a fire. A restaurant – with grills and ovens – or an auto repair shop will likely rate less favorably than an office. It’s important to remember that one relatively hazardous occupant will negatively impact the fire rating of an entire building. If your business is in a building with a more hazardous occupant, your premiums will be higher than they would be for your business alone.
  • Fire protection measures. Automatic sprinklers can reduce a building’s fire rating by as much as 50 percent. Buildings with fire extinguishers and automatic alarms and those located within 500 feet from a standard fire hydrant will generally have lower ratings.
  • Exposure. Nearby hazards increase a building’s fire risk. Proximity to external fire hazards such as a lumber yard or oil storage tank will negatively impact a fire rating to an even greater degree. Internal exposure risks might include cluttered building grounds, hazards posed by certain types of mechanical or electrical equipment, or on-site storage of volatile materials.

To learn the fire ratings of the individual structures on your business’ premises, ask your insurance agent. Your agent can access a statewide database of the ratings for all commercial properties. If you disagree with the rating assessed for any building your business owns or leases, first try to work with your agent, insurance company, and the inspector. If you are still dissatisfied, contact TDI’s Inspections and Fire Safety Office, the state’s final arbiter of disputed commercial property ratings

TDI Inspections and Fire Safety Office
PO Box 149104
Austin, TX 78714-9104
512-322 2259

Shopping for Commercial Property Insurance

One of the most effective ways to save on commercial property insurance is to begin shopping for coverage before you build, purchase, or lease a business property. Shopping in advance can help you understand exactly how a building’s characteristics will impact your premium.

Purchasing a commercial multi-peril policy can be another way to save. CMP policies combine multiple coverage forms into a single policy, typically for a lower premium than purchasing the coverage forms individually.

The following additional tips can also help you save money or avoid other pitfalls when buying a commercial property policy:

  • Minimize all possible risks before applying for coverage. Examine your business carefully for factors that could contribute to the likelihood of an insurance claim. Improving employee safety, security, and inventory management can reduce the amount you pay for commercial property insurance and other types of coverage, such as workers’ compensation and general liability insurance. Most insurance companies also offer loss-control or risk-reduction services. Contact your agency or company for help identifying potential risks and implementing plans to eliminate them.
  • Get quotes from several companies. Insurance companies can have significantly different rates, even for the same or similar coverages. It pays to shop around. When comparing prices, make sure you’re comparing policies with similar coverage. Keep in mind that, while one policy might be cheaper than another, it might also provide less coverage. In general, it’s best to buy the policy that provides the most coverage you can afford.
  • Consider higher deductibles. Higher deductibles can lower your premium, but remember that your out-of-pocket costs will be greater if you have a claim.

Help us prevent insurance fraud. To report suspected fraud, call our toll-free Fraud Hot Line


To report suspected arson or suspicious activity involving fires, call the State Fire Marshal’s 24-hour Arson Hot Line

1-877-4FIRE45 (434-7345)


Recent Texas Hurricanes

Don’t Be Caught Without Windstorm Insurance Coverage! - After the recent catastrophic hurricane seasons and with many people still trying to put their homes and lives back together, is your home covered for hurricane or other windstorm damage so you won’t be the next victim? If you live in one of the Texas' coastal counties, then you know how devastating and costly a storm can be. Don’t let an unexpected storm, like Rita, cost you. With the latest and most effective wind resistant construction, you will have a stronger structure and a better opportunity to obtain windstorm and hail insurance coverage through the Texas Windstorm Insurance Association or the voluntary market.


TWIA's territory includes the following fourteen (14) counties along the Texas gulf coast and parts of Harris county:

TWIA's territory includes the following fourteen (14) counties along the Texas gulf coast and parts of Harris county:






Harris County (partial)*







San Patricio







* Part of Harris County - When located inside city limits and east of highway 146, the following portions of Harris County are also included:






Shore Acres

Morgan's Point





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