Society Policy Request This form is only for Society Insurance Commercial Customers. Society Client Information COVID-19 Policy Request Business Name Contact Name Contact E-mail Address Contact Phone Number Reduce my General Liability Premium Choose One Yes No (If Yes) ESTIMATE OF Annual REDUCTION of sales up to 30% (If Yes) Estimated amount of time the order will be in effect (up to a maximum of 12 weeks) Reduce my Workers Compensation Premium Choose One Yes No (If Yes) Please confirm the Payroll reduction in dollars up to 30%