New York Links Quote Form

Course Name:

Street Address:

City:
State: Zip Code:
Owner's Name:

Phone:

E-Mail:

List all Losses in the last 3 Years:

Policy Expiration Date:

Current Insurance Company:

Total Premium:


Property

Buildings
Construction
Insured Value
Contents
Club House



Pro Shop



Storage



Loss of Income:
Deductible:

Equipment & Carts

Total Value:
Deductible:


Commercial General Liability

Type of Club:

Liability Limit:

Food Sales:

Umbrella:

 Number of Holes:

Number of Rounds:

Liquor Sales:

Course Access:


Commercial Automobile

Liability Limit:

Unisured Motorist:

Personal Injury Protection:

Vehicle
Year/Make/Model
Comprehensive
Collision
1



2



3




Workers Compensation

Country Clubs:

Restaurant:

Other:

 Number of Males:

Number of Females: