General Liability Insurance Quote

One Simple Form-takes only 2-3 Minutes!

       guaranteed response within 48 business hours!!

Don't want to fill out this form, well then call us now at 561-732-9305 or 1-800-397-8780 or click here and we will contact you!

General Liability Coverage

Liability Limit None 300,000 500,000 1,000,000 2,000,000 3,000,000 4,000,000

Amount of Employees (Full) (Part-Time)

Payroll without owners

Owner's Payroll

Professional Liability (Y/N) NO YES

If yes, we will either fax you or email you the supplemental application shortly.

Liquor Liability (Y/N) None Y

If yes, we will either fax you or email you the supplemental application shortly.

Any Additional Insureds (Y/N) N Y

If yes please list them and relationship

Square Footage you Occupy

Customer Area (Restaurants Only)

Do you have a deep fat fryer (restaurants and Bakeries only)? N Y

Any General Liability Claims in last 5 years? (Y/N) No Yes

Date of Loss

If Yes Please describe Below

Umbrella Policy NO YES

Umbrella Liability Limit None 1,000,000 2,000,000 3,000,000 4,000,000

 

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