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EDU-PRO New and Additional Location Questionnaire Form
EDU-PRO New and Additional Location Questionnaire Form
General Information:
Corporate Name & DBA:
Deleting a Location:
Are you deleting a location?
Yes
No
If Yes, please provide the following information:
Street:
City:
State:
Zip:
Date Deleted:
Address of New Location:
Street:
City:
State:
Zip:
Landlord’s Information:
Name:
Street:
City:
State:
Zip:
Please Answer Each Question:
Date to add new location:
Do you own the building this Center is in?
Yes
No
Year building was built?
Square Footage:
Number of Stories:
Linear feet of exterior glass:
Construction of building?
Frame
Masonry
Fire Resistive
Non-Combustible
Does your Center have a Central Station Fire/Burglar Alarm?
Yes
No
Does your Center have a Sprinkler System?
Yes
No
Business Property Limit: $
Tenants Improvements & Betterments: $
Do you wish to increase the payroll on your Workers Comp Policy?
Yes
No
If yes, enter New total payroll amount: $
Estimated Annual Gross Receipts
Δ