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Contractor Commercial Insurance
* = Required Information
This is not an instant quote website; our prices are too low to list online. Please fill out the quote form to obtain a Contractor Commercial insurance quote, and an insurance specialist will contact you shortly. Please understand this is not an application for insurance. An application will be sent to you if coverage is desired.
Proper Protection Fact Finding Questions
Of the following, what is the primary reason for quote request? Requesting More Information 
Required 
Replace Investment 
Liability Protection 
In the order of importance, what is most important to you? Price 
Service 
Proper Coverage 
Approximately when was the last time you did a review with your agent? Within the year 
Over 2 years ago 
Over 5 years ago 
Never 
Would you be interested in going to higher deductibles to reduce your premium? Yes 
No 
In the event of a lawsuit, accident, or judgment would you want to: Maximize Protection 
Assume Some Risk 
In the event of an untimely death, is it important to you that you're surviving spouse and/or children maintain the quality of life you currently have together without debt? Yes 
No 
Would you be interested in combining your commercial insurance for additional savings? Yes 
No 
If health insurance is provided for employees, would you like to save money? Yes 
No 
Requesting More Information 
Has your current company/agent failed to meet your expectations in any way? Yes 
No 
 
Contact Information
What else must I do to earn your business?
Contact Name
Business Name
Address
City
State
Zip Code
Business Phone Number
Primary Phone Number To Reach You
Fax
Email *
Contact Me During?
 
Insurance Information
Current Insurance Company
Current Policy Expiry
Current Amount Coverage
Liability Limit
Number of Years Insured
Losses and Claims for the Last 5 years
If yes, what is the date, amount paid and description of each loss or claim?
 
Business Information
Number of Owners
Number of Employees
Payroll of Owners
Payroll of Employees
Rent or Own Office
Annual Gross Receipts
Total Annual Sub Costs
Classification
Contractors License Number
License Type
Years Operated Under Current Name
Other Business Names
Construction or Remodeling:
Do you construct footings or foundations which may support dwellings or other structures?
Do you construct slab or monolithic floors?
Do you construct piers or underpinning which may support dwellings or other structures?
Do you construct retaining walls which may support dwellings or other structures?
Do you construct fireplaces or chimneys?
What is the percentage of work done as a General Contractor?
What is the percentage of work done as a Sub-Contractor?
What is the percentage of work done on Residential?
What is the percentage of work done on Commercial?
What is the percentage of work done for Remodeling?
What is the percentage of work done for Renovation?
What is the percentage of work done for Repair or Maintenance?
Any Additional Information