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Workers Comp. Sample Quote
The coverages and limits that follow are for illustration only and are not recommendations. We'll be pleased to provide a free quote for your specific coverage needs.
Barber Shop and Beauty Parlor
This example is based on an individual or small company with up to $334,679 annual gross payroll providing hair cut, manicure, pedicure, and related services. Premium will vary based on your actual payroll, your state, and the type of services you provide.
BEST INSURANCE COMPANY, Rated A+ XII, www.ambest.com
Agency Information Client Information
Name: Paperless Insurance Services FEIN: 55-5555555
Address: 5000A Geary Blvd Eff. Date:
City, State, Postal Code: San Francisco, CA 94118 Ann.Rating Date: N/A
Phone: 650-353-5868 Underwriter: Best Underwriter
Fax: Date:
Licensed Producer: Best Insurance Broker Company: Beauty Parlor
Quote Proposal
Thank you for giving us the opportunity to provide the following workers’ compensation quote for the captioned insured with Best Workers' Compensation Insurance Company. The quote is as follows:
State Code Description Payroll Rate Premium
CA 9568 Barber Shops Or Beauty Parlors (CA only) $334,679 3.12 10,442
Liability Limit $1MM/$1MM/$1MM 0
Experience MOD. 1.00 0
Ratings
CA Schedule Rating -0.05 -522
Premium Discount -536
Expense Constant 250
Terrorism Charge 3% 134
Surcharges
CA-CIGA 195
CA-WCAdminRevolving 105
CA-FRAUD 23
CA-SubsequentInjury 3
CA-UEBTFA 17
Final Premium $10,111
This quote is subject to the following:
- Signed and Completed workers' compensation application.
Payment Options
Plan Down Payment Percentage Down Payment
1-Pay 100% $10,111
2-Pay 60% $6,067
4-Pay 40% $4,044
10-Pay 15% $1,517
Accounts can NOT be bound by returning this form.
This quote is only valid until for 10 days. The information in generating this quote was submitted through the online underwriting system. All information is subject to verification. The terms of this quote are subject to change upon such verification. Policy premium is subject to audit
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