Real Estate E&O Form

Name: Intermarket Insurance Agency
Address: 205 East Main St, Huntington, NY, 11743, US
Telephone: (631) 421-2424

Insured's Contact Information
Insured's Name*
Insured's Company Name*
Phone*
Email*
Insured's Address*
Street Address Address Line 2 City State ZIP Code
Do you have a separate mailing address?*
- Yes
- No
Mailing Addres
Street Address Address Line 2 City State ZIP Code
Insured Corporation Type*
Is the insured independently owned and operated?*
- Yes
- No
What was the average sale price of residential properties sold by the applicant?*
Please enter a number from 0 to 5000000.
In what percentage of transactions did the applicant represent both the buyer and the seller?*
Please enter a number from 0 to 100.
Does the applicant have an existing and in-force Real Estate Professional Liability policy and require prior acts coverage?*
- No Existing/In-Force Policy
- Existing/In-Force Policy with a Retroactive Date
- Existing/In-Force Policy with Full Prior Acts
Policy Effective Date
MM slash DD slash YYYY
Revenues and Commission Income
For the Previous 12 months, what was the applicant's revenue? (Revenue over $500,000 will require a fully completed application to quote.)*
For the next 12 months, what is the applicant's expected revenue?*
Provide the number of employees in each of the below categories. (For brokers only. Individual agents do not need to complete.)
Full-time licensed agents/brokers*
Part-time licensed agents/brokers*
Full-time appraisers*
Part-time appraisers*
Full-time property managers*
Part-time property managers*
Provide the number of transactions of the applicant's annual revenue derived from
Real Estate Agent or Broker: Residential*
Please enter a number from 0 to 1000.
Real Estate Agent or Broker: Commercial*
Please enter a number from 0 to 1000.
Real Estate Agent or Broker: Agricultural*
Please enter a number from 0 to 1000.
Real Estate Agent or Broker: Raw land*
Please enter a number from 0 to 1000.
Property Manager: Residential*
Please enter a number from 0 to 1000.
Property Manager: Commercial*
Please enter a number from 0 to 1000.
Real Estate Appraisal: Residential*
Please enter a number from 0 to 1000.
Real Estate Appraiser: Commercial*
Please enter a number from 0 to 1000.
Are any of the revenues derived from BPOs, mortgage brokering, auctioneering, property development, or management of condominium associations?*
- Yes
- No
Does the applicant offer any of the following services or activities: property preservation, 1031 exchange, construction management, sale of timeshares, or mortgage banking?*
- Yes
- No
Are you aware of any act, error, or emission that may result in a claim?*
- Yes
- No
In the past 5 years, have you had any claims?*
- Yes
- No
I have completed this information to the best of my knowledge*
- Yes
- No
Name
This field is for validation purposes and should be left unchanged.

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Customer Reviews

HA

Intermarket Insurance Agency was there when we needed them!Homer a., Our Smart Place, L.L.C., Ocala, FL

EC

They are upbeat, quick to respond, and just an overall joy to work with.Ed C., Summit Learning Services, Plantation, FL

CH

I have already referred Intermarket and Vicky to another provider.Carole H., Sunshine State Star Students, LLC, Longwood, FL

KM

...thank you for an excellent customer service experience.Kraig M., Who Got Game, Stuart, Florida

CJ

You saved the day for us.Claudette J., New Life Child Care and Educational Center, Lauderdale Lakes, Florida

See All Reviews See All Reviews

Contact

Intermarket Insurance Agency

205 East Main St
Suite 3-4
Huntington, New York 11743

Phone: (631) 421-2424

Fax: (631) 421-2004

Mon-Thu: 9:00am-5:00pm
Fri: 8:30am-4:30pm
Sat-Sun: Closed

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Intermarket Insurance Agency Provides Auto/Car Insurance, Homeowners Insurance and Business/Commercial Insurance to All of New York, Including Huntington, Long Island, and Hempstead.

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Real Estate E&O Form

Insured's Contact Information

Revenues and Commission Income

Provide the number of employees in each of the below categories. (For brokers only. Individual agents do not need to complete.)

Provide the number of transactions of the applicant's annual revenue derived from