BLB Insurance Services 
15 Centre Pointe Dr.
St. Charles, MO 63004
Phone:  1-800-886-1564 or 636-720-1000
Fax:  636-720-1004 
info@blbinsurance.com

Christian Bookstore Insurance Service

Christian Bookstore Insurance Service (CBIS) is a subsidiary of BLB Insurance Services.   BLB Insurance Services specializes in creating programs for associations, buying-cooperatives and other affinity groups.  Programs are tailored to address the specific exposures unique to each organization.  As a policyholder, you can have confidence in knowing you have the right insurance protection for you business.  CBIS policyholders receive priority service on quotes, questions, claims, and other services.

If you would like a no-obligation quote please complete the form below.   When you are finished you can email or fax the form directly to Mike Bauer.  Your quote will be sent directly to you for review.

If you would like to discuss this program give Mike a call.

Store Name: *
Address: *
Address2:
County: *
City: * State:*
Zip: *
Contact Name: *
Phone: Ext.:
FAX : Ext.:
Email address:
How should we
reply to you?		 E-Mail    Phone
Fax    U.S Mail
Tax ID:
# of Locations: *
Annual Sales: *
Current Annual Premium:
Renewal Date:

Location #1:
Address is same as contact information above.
Address: *
Address2:
County: *
City: * State:*
Zip: *
Building
Construction:		 Frame    Masonry    Steel on Steel *
Sprinkler System: Yes     No *
Building Value (if Owned): $*
Contents Value: $*
Square Footage Occupied: *
Building Age (approximate): *
Is Glass Covered? Yes     No *
If yes, Please give square footage of glass:
Location #2:
Address: *
Address2:
County: *
City: * State:*
Zip: *
Building
Construction:		 Frame    Masonry    Steel on Steel *
Sprinkler System: Yes     No *
Building Value (if Owned): $*
Contents Value: $*
Square Footage Occupied: *
Building Age (approximate): *
Is Glass Covered? Yes     No *
If yes, Please give square footage of glass:
Location #3:
Address: *
Address2:
County: *
City: * State:*
Zip: *
Building
Construction:		 Frame    Masonry    Steel on Steel *
Sprinkler System: Yes     No *
Building Value (if Owned): $*
Contents Value: $*
Square Footage Occupied: *
Building Age (approximate): *
Is Glass Covered? Yes     No *
If yes, Please give square footage of glass:
 (Fields with ' * ' are required.)
If you require space for additional locations, please submit this form as many times as required to cover all locations.  Click on the Submit button below, or if you prefer, you can fax or mail the form to us at:

Fax: 314-298-3905

Mail:
BLB Insurance Agency
11520 St. Charles Rock Road
Suite 216
Bridgeton, MO  63044
ATTN: Mike Bauer