Chattanooga Lodge Organizations Quote

Lodge Organizations Insurance

Alder & Cox Insurance

Insurance Quote Request

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Lodge Information

Lodge Name ✶

Lodge Number

Mailing Address

Street Address

City

County

State

Zip Code

Contact Information

Contact Person ✶

Phone Number

Email Address ✶

Mailing Address

City

State

Zip Code

Structure Information

Date of Original Charter

Age of Building

Construction ✶

Updates to Building

Wiring

Heating

Roof

Plumbing

Width of Building

Length of Building

Number of Stories

Responding Fire Department

Distance to Fire Department

Number of Smoke Detectors

Number of Fire Extinguishers

List Kitchen Equipment

Insurance Information

Name of Current Insurance Company ✶

Annual Premium

Current Policy Renewal Date

Current Amount of Insurance on Building

Current Amount of Insurance on Contents

Does OES Meet at the Lodge?

Yes

No

Has the fraternity filed a claim with your present insurance company in the past three years?

Yes

No

Please provide additional information

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