Has your business suffered an economic loss due to COVID-19?*

Yes
No

Has COVID-19 been confirmed at your place of business?

Yes
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Who was confirmed with COVID-19

On what date did this happen?

I am sorry but we cannot help you at this time. Please contact us at (239) 791-7950 if you have any questions,

Corporate Information

Legal Registered Name*

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Annual Gross Revenue for the business:

Estimated lost revenues from COVID19:

Name of Authorized Business Representative*

First Last

Telephone Number*

EMAIL FOR LEGAL CORRESPONDENCE*

Business Interruption Insurance

Do you have Business Interruption Insurance?

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Name of Insurance Provider

Name of Underwriter (If Known)

Have you made a claim with your insurance provider?

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Event Cancellation Insurance

Do you have Event Cancellation Insurance?

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Name of Insurance Provider

Name of Insurance Underwriter

Name of Cancelled Event

Please Provide a Description of the Event

Date of the Event

Date of Cancellation

Have you submitted a claim for this event with your insurance provider?

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Tag: Danielle Levy Seitz

Aloia Roland partners recognized for excellence in the legal field

Family law attorney, Danielle Levy Seitz promoted to partner

Signs You Need to Hire a Child Custody Lawyer

Frank Aloia, Jr., Evan Lubell and Jack Morgan Awarded 2020 Florida “Super Lawyers” Distinction

Danielle Levy Seitz named Rising Stars honoree fourth year in a row

Corporate Information

Business Interruption Insurance

Event Cancellation Insurance

Aloia Roland partners recognized for excellence in the legal field

Family law attorney, Danielle Levy Seitz promoted to partner

Signs You Need to Hire a Child Custody Lawyer

Frank Aloia, Jr., Evan Lubell and Jack Morgan Awarded 2020 Florida “Super Lawyers” Distinction

Danielle Levy Seitz named Rising Stars honoree fourth year in a row

COVID-19 Business Impact Questionnaire

Corporate Information

Business Interruption Insurance

Event Cancellation Insurance