Commercial Property Application

Please submit this application for business and commercial property located in Mexico.

Proposed Effective Date
Name of Agent or Broker
Company
E-mail
Website
Phone Number

    Fax

Insured Name in the US (if applicable)
Insured US Address

Street:
City:   State:   Zip:
Insured Name of Mexico Entity


 for more than one, please schedule on a separate form
Insured Address of Mexico Entity

Street:
City:   State:   Postal Code:

Value:

 Building: Contents: Equipment:
Flood Coverage: insuring: Buildings     Contents
Earthquake Coverage: insuring: Buildings     Contents
Occupancy and brief description of Mexico operation:
Construction Type:
Number of Stores:
Fire Protection Equipment: Extinguisher     Fire Hydrant     Sprinklers
Number of Units:
Current Insurer:                    Yearly Premium
Loss History (if available) last 3 years:
CGL Liability Limit:
Include Products?		 Burglary Theft Limit:
  Cash & Securities Limit:
EDP Computer Limit: Boiler & Machinery Limit:
Glass Coverage Limit: Loss of income Limit:

Transit: Click here for an additional transit application.

Automobile Fleet Information:  Vehicles are registered in USA     Mexico

Vehicle 1:

Year   Make  Model   Value

Vehicle 2: Year   Make  Model   Value
Vehicle 3: Year   Make  Model   Value
Vehicle 4: Year   Make  Model   Value

For additional vehicles, email a statement with year, make, model and value of each vehicle to jim.labelle@mexpro.com
 

If you have additional buildings, please enter a statement of values or email a list to jim.labelle@mexpro.com.

Statement of values for additional buildings:


 

 

 

 

Mexico Insurance Professionals
an International Insurance Group, Inc. company
121 E. Birch Avenue, Suite #207, Flagstaff, AZ 86001
Toll Free (888) INS-4-MEX
Phone (928) 214-9750   Fax (928) 213-8476

 We gladly honor:

 

 
 
 
 

Agents in USA, Canada and Mexico     © 2000-2004 International Insurance Group
CA License #OA99044 DBA Mexico & RV Insurance Services
If you have any technical questions or comments regarding the operation of this web site, please send e-mail to mexico@mexpro.com