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Nail Salon Insurance Mission Statement
  Nail Salon Name:
  Contact Name (First & Last):
  Address:
  City:
 
State:
   Zip Code:
  
  
 
Phone:
   Ext:
  
  
  Fax:
  Email:
  Website:
 Insurance Info
  Do you currently have insurance?
YesNo
  If 'Yes', when does your policy expire?
  If 'Yes', what is your premium?
  If 'Yes', who are you currently insured with?
 Business Info
 Sole Proprietor
Partnership
Corporation
LLC
Association

  Type & Description of Nail Salon:
  Year Established:
 
  Number of Locations:
  Approximate Annual Sales:
  Approximate Total Payroll:
 
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Beauticians Liability Group Health
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  Comments
 
 
 

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