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Business insurance application.

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Business Insurance Application

Love that you’re interested in teaming with Shine. Please provide a few bits of info below and we’ll reach out with next steps.

"*" indicates required fields

Step 1 of 3

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First Name*

Last Name*

Business Name*

Mailing Address*

Street Address* Address Line 2 City* State* ZIP Code*

Phone*

(###)###-####

Email*

Enter Email* Confirm Email*

How did you hear about Shine?*

Website

What does your business do?*

How many years has this entity been in business?*

Just starting

1-2 Years

3-5 Years

6 Years +

How many years of management experience do you have in the industry?*

In what state is your business registered?*

How many locations do you have?*

1-5

Will you be attaching a document that lists your locations?*

No, I can list them here

Yes, I'll attach a document

Please list the address of each location*

Please attach a list of locations*

Max. file size: 300 MB.

How many employees do you have?*

1-5

What is your total payroll?*

Will you be attaching a document that lists your employees?*

No, I can list them here

Yes, I'll attach a document

Please list the names of your employees*

Please attach a list of employees*

Max. file size: 300 MB.

How many vehicles are owned in the business name?*

1-5

Will you be attaching a document that lists your vehicles?*

No, I can list them here

Yes, I'll attach a document

Please list the Yr, Make, Model of each vehicle*

Please attach a list of vehicles*

Max. file size: 300 MB.

What is your projected annual revenue for the next year?*

What is your FEIN?

Does your business have a board of directors?

Yes

Does your business have any tools or equipment?*

Yes

What total value would you put on your tools & equipment?*

Are any tools valued at more than $2500?*

Yes

Please list tools valued more than $2500 & their value*

If you have a long list please attach on the next page

Are they any specific concerns or coverages we should address?

Please attach your current policies

Max. file size: 300 MB.

Please attach any supporting documents

Max. file size: 300 MB.

This field is for validation purposes and should be left unchanged.

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