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 Liquor Liability 
Form: Liquor Liability Insurance Quote
Liquor Liability Insurance Quote




Contact Information
First Name:
Last Name:
Daytime Telephone:
Evening Telephone:
Email:
Address:
City:
State:
Zip:
Location Information: (if different from above)
location address:
city:
state:
zip:
Business Information
How long at this location: Years Months
Year in business: Years Months
Name on license:
Expiration date of license:
Describe your operation:
(ie... private club, gas station, tavern or bar with nightclub entertainment, etc)
Current/Previous Insurance:
Current/Previous Insurance Carrier:
Premium: $
Limits: $
Policy Number:
Effective Date:
Comments or Questions
Deliver quote via
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No coverage of any kind is bound or implied by submitting information via this online form
We value your privacy. Every precaution has been taken to insure your privacy and security. Our intent is to release information to you only. We will not provide your data to any third party or group for sales, marketing, or any other purposes. By submitting this form, you agree to release us from any liability should this information be accidentally viewed by others.

By completing this form, you are acknowledging your understanding of and agreement with these terms


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The Hanks Group
8238 E. RL Thornton Fwy Suite D
Dallas, TX 75228


Toll Free: 877-275-8372
Phone: 214-275-8372  fax: 214-275-8375
email: info@hanksgroup.com

© Copyright 2006
IMPORTANT NOTE: descriptions of insurance coverage on this web site are for informational purposes only and may not apply, or be included on your policy. Please contact us to confirm coverage provided on your insurance policy or policies your are contemplating purchasing. Coverage may not apply in all states. For complete details of coverages, conditions, limits and losses not covered, be sure to read the policy, including all endorsements.
READ OUR PRIVACY STATEMENT

 

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