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Business Insurance Checklist

General Information
Name*
Legal Name of Business
Business Phone*
Email*
Business Address
Street Address Address Line 2 City State ZIP Code
Insurance Needs
Choose Lines of Insurance You Are Interested In
- Commercial Auto
- Aviation
- Business Interruption
- Commercial Property
- Commercial Liability
- Contractor General Liability
- Hotel/Motel
- Liquor
- Medical Malpractice
- Office Pkg/Prof. Liability
- Product Liability (E&O)
- Restaurant
- Special Events
- Workers' Compensation
- Other
Other (Please Explain)
Current Insurance Information
Insurance Company Name (Not Agency Name)
Premium Amount
Years Insured
Policy Expiration Date
MM slash DD slash YYYY
About Your Business
Number of Employees
Number of Locations
Years in Business
Annual Sales
Detailed Description of Your Business
Additional Comments or Questions
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Customer Reviews

SP

5 stars!S.P., Monticello, New York

Ian and Juanita are awesome! Will call you if there is a better deal than your...P.S., Monticello, New York

CD

Top rated companies exceptional experienced staffC.D., Monticello, New York

MG

Very pleasant to deal with!M.G., Monticello, New York

RC

Thank you for answering all my questions and explaining how everything work...R.C., Monticello, New York

The staff was very helpful. Can not say enough kind things about themG.C., Monticello, New York

SD

You can't put a price on peace of mind...Thanks Merrell Benco!S.&., Thompson, New York

MT

Our Home, Business, Cars and Boat! I trust them with everything!M.T., Kauneonga Lake, NY

JS

Personalized and professional service no matter what!J.&., Bethel, NY

CH

Our go-to insurance company forever, from my parents to now me and my family!C.H., Jeffersonville, NY

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Contact

Merrell Benco Insurance Agency

67 East Broadway
Monticello, New York 12701

Phone: (845) 796-1500

Fax: (845) 796-1296

Mon-Fri: 8:30am-5:00pm
Sat-Sun: Closed

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Merrell Benco Insurance Agency provides Auto Insurance, Homeowners Insurance, and Business Insurance to all of New York, including Monticello, Liberty, and Rock Hill.

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