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Commercial Insurance Quote
Protect your business, assets, and bottom line. Get comprehensive commercial insurance coverage tailored to your operations.
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Business Overview & Contact Details
Legal Business Name
*
Doing Business As (DBA) Name
Primary Contact Person
*
First
Last
Title / Position
*
Contact Phone Number
*
Contact Email Address
*
Main Business Street / Physical Address
*
Address Line 1
Address Line 2
City
--- Select state ---
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Business Website URL
Entity Type
*
LLC
Corporation
Sole Proprietorship
Partnership
Non-Profit
Date Business Established
*
Years in Business
*
Federal Employer Identification Number (FEIN / Tax ID)
*
Business Operations & Financials
Detailed Description of Business Operations
*
Primary Industry / Business Classification
*
Retail
Restaurant / Food Service
Construction / Contracting
Professional Services
Wholesale / Distribution
Manufacturing
Real Estate / Property Owner
Other
Estimated Annual Gross Revenue / Sales ($)
*
Estimated Annual Payroll ($)
*
Total Number of Full-Time Employees
*
Total Number of Part-Time Employees
*
Do you hire Subcontractors / Independent Contractors?
*
Yes
No
Estimated Annual Subcontractor Cost ($)
*
Do you collect Certificates of Insurance (COIs) with proof of limits from all subcontractors?
*
Yes
No
Commercial Auto & Fleet Info (Optional)
Does your business own or use vehicles for business operations?
*
Yes
No
Number of Commercial Vehicles Owned
Do employees use personal vehicles for business trips/errands?
Yes
No
Do you conduct DMV motor vehicle record checks on drivers?
Yes
No
Carrier (FEIN lawsuits
Loss History & Safety
Have you had any commercial insurance claims, losses, or lawsuits in the past 5 years?
*
Yes
No
Please describe the date, type of loss, and total payout or estimated amount.
*
Do you currently have commercial insurance?
*
Yes
No
Current Insurance Carrier Name
*
Policy Expiration Date
*
Desired Coverages & Limits
Coverages Requested
Commercial General Liability
Commercial Property / Building & Inventory
Business Interruption / Loss of Income
Workers' Compensation
Commercial Auto
Cyber Liability / Data Breach
Professional Liability / E&O
General Liability Desired Limit
$1,000,000 / $2,000,000
$2,000,000 / $4,000,000
Desired Property Deductible
$1,000
$2,500
$5,000
$10,000
Submit
