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Fields marked (*) are mandatory.
General Liability Information
Location 1
Class Code #*
The 5-digit code found on the general Liability declaraction page. Example: 97047-Landscape gardening
Classification Description
Premium Basis
Location 2
Class Code #
Classification Description
Premium Basis
Location 3
Class Code #
Classification Description
Premium Basis
Liability
General Aggregate Limit (A)
Products/Completed Operations Aggregate Limit (C)
Personal/Advertising Injury Limit (G)
Each Occurrence (H)*
Fire Damage Limit - Any One Fire (E)
Medical Expense Limit - Any One Person (D)
Liability Endorsements - Additional Information