Contractor Insurance Quote

Contractor Information

Type of Business Sole Proprietor Corporation Partnership LLC

Contractor Type Dry Wall Electrician Painter Plumber Roofer General

Business Name

Contact Person

Phone No.

Email

Street Address

City, State, Zip Select AK AL AR AZ CA CO CT DC DE FL GA HI IA ID IL IN KS KY LA MA MD ME MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA PR RI SC SD TN TX UT VA VT WA WI WV WY

Fax No.

Years in Business

Claims in last 3 years? No Yes

If Yes, claim details

Number of Employees

Total Payroll

Bankruptcies/Tax Liens in last 3 years? No Yes

Policy Effective Date

Policy Renew Date

Number of Vehicles to Insure

Approx. Current Premium

Current Insurance Carrier

Estimated Gross Sales

Subcontractors Used? No Yes

If Yes, percentage subcontracted out

Percentage of Commercial Business

Percentage of Residential Business

New Construction Work (%)

Remodeling Work (%)

Repair Work (%)

Do you want tool coverage? No Yes

If Yes, how much?

Amount of Coverage $300,000 $500,000 $1,000,000

Do you rent equipment regularly? No Yes

Do you need a bond? No Yes

I accept the terms