Trade Contractors Quote

Trade Contractors Insurance Quote

Trade Contractors General Liability Insurance

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Company Name
Your Name
Title
Type of Company
Mailing Address City, ST Zip	, ,

County
E-mail
Phone
Fax
Company Website
How Did you hear about us?	If referral If referral please provide name we send like to reward anyone who refers us clients
How would you like us to send you the quote?
Why Do you want to leave your current insurance company?

What Does your Business Do?
Federal Employer Identification Number
Years in Business
Current Ins Carrier	2008-Insurance Company Name Policy Number Expiration Date How many years have you been with them?
Do you sub-contract any work out to others? How Much %?	If you sub contract over 20% we will not be able to help you.
Years Experience in this type of business
Sales (Annually)
Liability Limit
Amount of Employees	(Full) (Part-Time)
Payroll without owners
Amount of Owners
Any Additional Insureds (Y/N)
If Yes How Many
Any General Liability Claims in last 5 years? (Y/N)
Date of Loss	If Yes Please describe
Do you want a quote on a Tool Floater?	If so how much coverage do you need?

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Comments/Questions

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