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Small Business Insurance
Application for Small Business Insurance Coverage
We invite you to get our most competitive small business insurance quotes for your business. Complete one short form below and we'll shop multiple carriers on your behalf and email you the best offers. Plus, as a value-added service, our in-house licensed attorney can review your exposures and consult you on insurance absolutely free of charge.
Are you looking for insurance coverage for Amazon.com or other online seller?
*
Yes
No
Do you manufacture, import, private label or drop ship any products?
*
Yes
No
STOP
- in order to get a proper coverage
click here
to be redirected to our
Product Liability Insurance Application
Keywords to describe your business
*
-- Select Your Industry --
Abrasives Manufacturing
Abstracting and Indexing Service
Accounting & Finance Software
Accounting Service
Accounting Services
Adjuster Public or Independent Claim Adjuster
Advertising
Advertising & Marketing Services
Advertising Agencies
Aerospace Products & Parts Manufacturing
Agricultural Chemical Manufacturing
Agricultural Machinery Manufacturing
Agriculture & Forestry Sector
Aircraft Engine & Parts Manufacturing
Aircraft Leasing
Aircraft Maintenance & Repair
Airlines
Airport Operations
Aluminum Production
Ambulance Services
Ambulatory Health Care Services
Ambulatory surgical centers
Amusement Parks & Arcades
and propellants
Anesthesiologists
Anesthesiologists, offices of
Animal Production
Antique Gallery / Shop
Apparel Accessories Manufacturing
Apparel Manufacturing
Appraisal Service
Aquaculture
Architectural & Engineering Services
Architectural & Structural Metals Manufacturing
Architectural Services
Armored Military Vehicle Manufacturing
Armored Vehicle Services
Art Dealers & Galleries
Art Gallery / Art Studio
Artist Supplies
Arts, Entertainment & Recreation Sector
Asphalt Products Manufacturing
Asset Management
Auctioneer
Audio & Video Equipment Manufacturing
Auditor
Auto Lending
Automobile Dealers
Automobile Manufacturing
Automobile Parts Manufacturing
Automobile Rental & Leasing
Automotive Oil Change & Lubrication Services
Automotive Parts & Accessories Stores
Automotive Repair & Maintenance Services
Bakeries
Bakery Product Manufacturing
Balloon Art
Balloons, gift baskets, etc.
Bands
Banks & Credit Unions
Barber Supplies
Barbers
Bars & Nightclubs
Battery Manufacturing
Beauticians
Beauty Supplies
Bed & Breakfast Inns
Beer, Wine & Distilled Spirits Wholesalers
Beer, Wine & Liquor Stores
Beverage Vendor
Billing Service
Biofuel Manufacturing
Biotechnology Product Manufacturing
Biotechnology Research Services
Boat Building
Boat Dealers
Book / Magazine Distributor
Book Publishers
Bookbinding
Bookkeeping Service
Bookstores
Bowling Centers
Breakfast Cereal Manufacturing
Breweries
Building Material Dealers
Bus Transportation Services
Business & Professional Associations
Business Intelligence Software
Business Service Centers & Copy Shops
Business Services Sector
Calligraphy
Camera / Photography Sales or Repair
Candle Sales, excluding sales of candles made by individuals
Candy / Nut Confections
Candy Manufacturing
Car Detailer
Car Washes
Cardiologists
Carpet & Rug Manufacturing
Casual Restaurants
Catering Services
Cattle Ranching
Cell Phone / Pager Sales
Cement & Concrete Product Manufacturing
Ceramics
Charter & Other Nonscheduled Air Transportation Services
Chemical Manufacturing
Chemical Wholesalers
Child Care Services
China & Earthenware Plumbing Fixture Manufacturing
Chiropractors
Clay Product & Refractory Manufacturing
Clinics of physicians (M.D.)
Clock or Watch Repair
Clothing Stores
Clowns, Magicians, Entertainers
Coal Mining
Coastal & Great Lakes Freight Transportation
Coffee & Tea Manufacturing
Coffee Shops
Collection Agencies
Colleges & Universities
Commercial & Heavy Construction Contractors
Commercial & Industrial Equipment Rental & Leasing
Commercial Fishing
Commercial Printing
Commercial Real Estate Brokerage
Commercial Real Estate Brokerage & Management
Commercial Real Estate Management
Community Colleges
Commuter Rail Systems
Computer & Office Equipment Wholesalers
Computer Consultants and Trainers
Computer Manufacturing
Computer Networking Equipment Manufacturing
Computer Peripheral Equipment Manufacturing
Computer Repair
Computer Sales
Computer Service Bureau
Computer Software
Concrete & Masonry Contractors
Construction Machinery Manufacturing
Construction Sector
Consulting Services
Consumer Electronics & Appliances Stores
Consumer Lending
Consumer Product Rental
Consumer Services
Content & Document Management Software
Control, Electromedical, Measuring & Navigational Instruments Manufacturing
Convenience Stores & Truck Stops
Converted Paper Products Manufacturing
Cookie & Cracker Manufacturing
Copper & Nickel Mining
Cosmetic Sales Avon, Mary Kay, etc.
Cosmetics, Beauty Supply & Perfume Stores
Crafts
Credit Cards
Credit Reporting & Collections Services
Credit Reporting Services
Crop Production
Crude Petroleum Pipelines
Cruise Ships
Custodial & Trust Services
Customer Relationship Management, Marketing & Sales Software
Dairy Products Manufacturing
Dance Instructors
Data Storage Systems Manufacturing
Database & File Management Software
Database Management
Deep Sea Freight Transportation
Dentists
Department Stores
Dermatologists
Dermatologists, offices of
Desktop Publishing
Dessert Vendors
Development of custom computer applications / programs
Development Tools, Operating Systems & Utilities Software
Diagnostic Substance Manufacturing
Digital Advertising Services
Direct Marketing Services
Direct Selling
Directory & Mailing List Publishers
Disc Jockeys
Discount Department Stores
Distilleries
DJ’s
Dollar & Other General Merchandise Stores
Draftsman
Drug Stores
Drug Wholesalers
Dry Food Products / Mixes Vendor
Drywall, Plaster, Acoustic & Insulation Contractors
E-commerce Software
Edible Oils Manufacturing
Editorial Service / Proofreaders
Education & Training Services
Education & Training Software
Education Sector
Electric Power Generation
Electric Power Transmission, Distribution & Marketing
Electric Utilities
Electrical Contractors
Electrical Products Manufacturing
Electrical Products Wholesalers
Electrical, Plumbing & Hardware Wholesalers
Electromedical, Electrotherapeutic & X-Ray Apparatus Manufacturing
Electronic Component Wholesalers
Electronic Equipment Repair Services
Electronic Inspection & Monitoring Instruments Manufacturing
Electronic Test & Measurement Instruments Manufacturing
Electronic Toys & Games Manufacturing
Embroidery
Energy Provider
Engineering Services
Engineering, Scientific & CAD/CAM Software
Engraving
Enterprise Resource Planning Software
Entertainment & Games Software
Environmental Consulting Services
Erosion Control Services
Executive Search Services
Expert Witness Consultants
Express Delivery Services
Exterminating & Pest Control Services
Eyewear Manufacturing
Fabricated Metal Product Manufacturing
Farm & Garden Equipment Wholesalers
Farm Support Services
Fast-Food & Quick-Service Restaurants
Film & Video
Finance & Insurance Sector
Financial Planners & Investment Advisers
Financial Planning
Financial Transaction Processing
Fitness Centers
Fitness Equipment Manufacturing
Floral Arrangement
Florists
Food / Product Demonstrator
Food Broker
Food Manufacturing
Food Product Machinery Manufacturing
Food Service Contractors
Food Supplements / Vitamins
Food Wholesalers
Footwear Manufacturing
Fossil Fuel Power Generation
Framing Contractors
Freestanding emergency medical (M.D.) centers
Freight Forwarding Services
Fresh Prepared Foods
Fresh Produce Wholesalers
from vending machines
Fruit & Tree Nut Farming
Fruit & Vegetable Processing
Fuel Oil & LP Gas Dealers
Funeral Services
Furniture Manufacturing
Furniture Refinishers
Furniture Stores
Gambling
Games / Puzzles Vendor
Garden Centers & Farm Supply Stores
Gas Stations
Genealogists
General Surgeons
Geophysical Surveying & Mapping Services
Gift Delivery Service
Gift Shop
Gift, Novelty & Souvenir Stores
Glass & Glass Product Manufacturing
Glassware
Gold & Silver Mining
Golf Courses
Government
Grain Farming
Grain Milling
Grantmaking Foundations
Graphic Artist / Designer
Graphic Design Services
Greeting Card Publishers
Grocery Stores & Supermarkets
Guided Missile & Space Vehicle Manufacturing
Gun & Ammunition Manufacturing
Gynecologists, offices of
Hair Care Services
Handicrafts
Handtool, Cutlery, & Flatware Manufacturing
Hardware & Fastener Manufacturing
Hazardous Waste Services
Health Care Management Software
Health Care Sector
Health Fund-raising Organizations
Health Insurance Carriers
Health Supplement Stores
Hearing Aid Sales
Hedge Fund Management
Highway, Street, & Bridge Construction Contractors
Hobby & Model Supplies, excluding explosives
Hog and Pig Farming
Home Centers & Hardware Stores
Home Furnishings Stores
Home Furniture & Housewares Stores
Home Health Care Services
Homeowner Associations
Hospitals
Hot Dog / Pretzel Vendors
Hotels, Motels & Resorts
Household Appliance Manufacturing
Household Appliance Stores
Household Products Fuller Brush, etc.
Human Resources & Workforce Management Software
Human Resources Consulting Services
HVAC Equipment Manufacturing
Industrial Chemical Manufacturing
Industrial Control Products Manufacturing
Industrial Equipment Wholesalers
Industrial Supply Wholesalers
Information & Records Management Services
Information Search Retrieval
Information Technology Services
Inland Water Freight Transportation
Insurance Agencies & Brokerages
Insurance Agent
Insurance Carriers
Interior Decorating
Interior Design Services
Interior Window Treatments
Internet & Mail-Order Retail
Internet Auctions
Internet Publishing, Broadcasting & Search Portals
Inventory Control Specialist
Investment Banking
Investment Firms
Janitorial & Carpet Cleaning Services
Jewelry Costume
Jewelry Manufacturing
Jewelry Stores
Kidney Dialysis Centers
Kitchen Supplies Tupperware, etc.
Labor Unions
Ladies / Girls Clothing, Accessories
Landscaping Services
Laundry Facilities & Dry Cleaning Services
Leather Goods
Legal Services
Lending
Less-Than-Truckload Carriers
Life Insurance Carriers
Lighting Equipment Manufacturing
Linen & Uniform Supply Services
Linens Manufacturing
Lingerie
Livestock & Other Animal Food Manufacturing
Loan Origination Service
Locksmith
Lodging
Lumber & Plywood Product Manufacturing
Lumber Wholesalers
Luxury Automobile Dealers
Machine Shops
Machinery Manufacturing
Magazine Publishers
Magnetic & Optical Media Manufacturing
Magnetic & Optical Media Manufacturing & Reproduction
Managed Application & Network Services
Management of Companies & Enterprises
Manufactured Home Manufacturing
manufacturing
Manufacturing / distribution of candles made by individuals
Manufacturing Sector
Marinas
Market Research
Market Research & Polling Services
Material Handling Equipment Manufacturing
Mattress Manufacturing
Meat Product Manufacturing
Media
Medical & Diagnostic Laboratories
Medical Claims Processing
Medical Equipment & Supplies Manufacturing
Medical Equipment & Supply Wholesalers
Membership Organizations
Mens / Boys Clothing, Accessories
Men's Clothing Manufacturing
Mental Health & Substance Abuse Services
Mental Health Professionals
Messaging, Conferencing & Communications Software
Metal Coating, Engraving & Heat Treating
Metal Ore Mining
Metal Valve & Pipe Fitting Manufacturing
Metalworking Machinery Manufacturing
Mining
Models
Monogramming
Mortgage Banking
Motion Picture Production & Distribution
Motor & Generator Manufacturing
Motor Vehicle Towing
Motorcycle Dealers
Motorcycle Manufacturing
Movie Theaters
Moving Services
Multimedia, Graphics & Publishing Software
Museums, Zoos & Parks
Music Production & Distribution
Musical Instrument Manufacturing
Musical Instrument Sales / Repair
Musical Instrument Stores
Mutual Fund Management
Natural Gas Distribution & Marketing
Natural Gas Pipelines
Neurologists, offices of
Newspaper / Magazine / Book Delivery
Newspaper Publishers
Nonalcoholic Beverage Manufacturing
Nonclassifiable establishments
Nonmetallic Mineral Mining & Quarrying
Nonmetallic Mineral Product Manufacturing
Nonprofit Institutions
Nonstore Retail
Notaries
Nuclear Power Generation
Nursery & Floriculture Production
Nursing Homes & Long-Term Care Facilities
OBGYNs
Obstetricians, offices of
Oculists, offices of
Office Furniture, Fixtures & Equipment Manufacturing
Office Supplies Vendor
Office Supply & Paper Wholesalers
Office Supply Stores
Office, School & Art Supplies Manufacturing
Oil & Gas Exploration & Production
Oil & Gas Field Equipment Manufacturing
Oil & Gas Field Services
Oil & Gas Transportation & Storage
Oil & Gas Well Drilling
Oilseed Farming
Oncologists
Ophthalmologists, offices of
Opticians
Optometrists
Orthopedic physicians, offices of
Outpatient Surgical Centers
Paint & Coating Manufacturing
Paint & Wallpaper Stores
Painting & Wall Covering Contractors
Paper & Paper Products Manufacturing
Paper Goods
Parking Lots & Garages
Pathologists (M.D.), offices of
Pay Telephone Provider
Payroll Services
Pediatricians
Pediatricians, offices of
Performing Arts Companies
Personal Care Products
Personal Care Products Manufacturing
Personal Computer Manufacturing
Personal Fitness Trainer
Personal Image Consultants
Personalized Books & Gifts
Pet & Pet Supplies Stores
Pet Accessories
Pet Food Manufacturing
Pet Sitters
Petroleum & Coal Products Manufacturing
Petroleum & Petroleum Products Wholesalers
Petroleum Refining
Pharmaceutical Manufacturing
Photographer / Photography Studio
Photographic & Optical Equipment/Supplies Manufacturing
Photographic Services
Physicians
Physicians (M.D.), including specialists: offices and clinics of
Picture Framing
Plant Care and Sales
Plastic & Rubber Product Manufacturing
Plastic Resin & Synthetic Fiber Manufacturing
Plastic surgeons, offices of
Plumbing & HVAC Contractors
Podiatrists
Port, Harbor & Marine Terminal Management
Postal Services
Poultry Product Manufacturing
Power Line & Telecommunications Infrastructure Construction Contractors
Power Tool & Lawn/Garden Equipment Manufacturing
Prefabricated Wood Building Manufacturing
Prepaid Calling Card Vendor, excluding sales
Prescription Benefits Management
Primary care medical (M.D.) clinics
Primary Metals Manufacturing
Printer
Printing Machinery & Equipment Manufacturing
Private Households
Private Schools K-12
Professional Employer Organizations
Professional Organizer
Professional Services Sector
Professional Speakers
Professional Sports Teams & Organizations
Property/Casualty Insurance Carriers
Psychiatrists, offices of
Psychoanalysts, offices of
Public Relations Services
Public Schools K-12
Publisher
Publishing
Pulp & Paper Mills
Radio Broadcasting & Programming
Radiologists, offices of
Railroad Equipment Manufacturing
Railroads
Real Estate
Real Estate Agent
Real Estate Investment Trusts (REITs)
Recreational Vehicle Dealers
Recreational Vehicle Manufacturing
Recreational Vehicle Parks
Recyclable Material Wholesalers
Refined Petroleum Pipelines
Rehabilitation Therapy Services
Reinsurance Carriers
Religious Goods
Religious Organizations
Remediation & Environmental Cleanup Services
Rental & Leasing
Residential Construction Contractors
Residential Inspection Services
Residential Property Investment
Residential Real Estate Brokerage & Management
Residential Real Estate Development
Restaurants
Restaurants, Bars & Food Services
Resume Service
Retail Sector
Retail Toy Sales
Retirement & Pension Management
Roofing, Siding, & Sheet Metal Contractors
Rubber Stamp Business
Sales Promotion Services
Scientific & Technical Instruments Manufacturing
Scientific Research & Development Services
Scrapbooking
Seafood Processing
Search, Detection, Navigation & Guidance System Manufacturing
Seasoning & Dressing Manufacturing
Secretarial Service
Securities Brokerages
Security Guard Services
Security Products Manufacturing
Security Software
Security System Services
Seed Sales
Self-Storage Services
Semiconductor & Other Electronic Component Manufacturing
Semiconductor Equipment Manufacturing
Shipbuilding & Repairing
Shoe Repair
Shoe Stores
Sign Manufacturing
Sign Painting
Site Preparation Contractors
Ski Facilities
Snack Foods Manufacturing
Soap & Other Detergent Manufacturing
Social Assistance
Soft Drink Manufacturing
Solar Power Generation
Solid Waste Services & Recycling
Spa Services
Special Effects & Other Video Post-Production Services
Specialty Contractors
Specialty Eateries
Specialty Food Stores
Specialty Trucking
Sporting Goods Manufacturing
Sporting Goods Stores
Staffing Services
Stationery
Steel Production
Steel Service Centers & Other Metal Wholesalers
Stenciling
Stock Exchanges
Sugar Manufacturing
Supply Chain Management & Logistics Software
Surgeons (M.D.), offices of
Surveillance, Investigation & Security Consulting Services
Switch, Connector & Other Wiring Device Manufacturing
Tailoring, Alterations, Seamstresses
Talent & Modeling Agencies
Tax Preparation
Taxi & Limousine Services
Taxidermist
Teachers / Tutors, including physical education, industrial or martial arts
Technology & Office Equipment Leasing
Telecommunications Equipment Manufacturing
Telecommunications Resellers
Telecommunications Services
Telemarketing, Telephone Solicitation
Telephone Answering Service / Voicemail
Telephone Call Centers
Television Broadcasting
Testing Laboratories
Textile Manufacturing
Timber Operations
Tire Dealers
Tire Manufacturing
Tire Wholesalers
Title Insurance Carriers
Tobacco Product Manufacturing
Toner Cartridge Recharging
Toy & Game Manufacturing
Toy & Hobby Stores
Trade Show & Event Planning Services
Transcribing, Court Reporters
Transformer Manufacturing
Translator
Transportation Equipment Manufacturing
Transportation Services Sector
Travel Agencies & Services
Travel Agent
Trophy Sales
Truck & Bus Manufacturing
Truck Rental & Leasing
Truck Trailer Manufacturing
Trucking
Truckload Carriers
Turbine Manufacturing
TV / VCR Repair
TV Broadcast & Cable Networks
TV Program Production & Distribution
Upholsterer
Urologists, offices of
US Municipal Governments
Used Merchandise Stores
Vegetable and Melon Farming
Vending Machine Operators
Venture Capital
Veterinary Services
Video & Music Sales / Rental
Videotaping, Dubbing, Editing
Vinyl / Leather Repair
Vinyl Lettering
Vitamin, Nutritional Supplement & Other Health-Related Product Manufacturing
Warehouse Clubs & Superstores
Warehousing & Storage
Waste Management Services
Water & Ice Manufacturing
Water & Sewer Utilities
Water Transportation Services
Website Designer
Wedding & Party Planners
Wedding Cake and / or Cookie Sales
Weight Reduction Services
Wholesale Sector
Wind Power Generation
Windshield Repair
Wineries
Wired Telecommunications Services
Wireless Networking Equipment Manufacturing
Wireless Telecommunications Equipment Manufacturing
Wireless Telecommunications Services
Women's Clothing Manufacturing
Wood Flooring Manufacturing
Wood Furniture Crafters
Wood Product Manufacturing
Wood Products, excluding toys and furniture
Wood Window & Door Manufacturing
Word Processing
Writers / Authors
Other
Select or enter words that describe the primary service you offer or type of product you sell. Not seeing anything that matches your business? Try typing in different words, select "Other" or contact us for assistance.
Do you offer additional services?
*
Yes
No
Answer "yes" if you offer services not included in your business description. Examples of businesses that offer additional services: a lawn maintenance firm that plows snow in the winter; a lawyer that sells real estate on the side; or a real estate agent that also manages properties.
Additional Services
*
Number of employees
*
Include everyone on your payroll. Don't forget to include the owner, officers, partners, members, employees who work from home and anyone on the payroll.
What types of insurance are you looking for?
Property
Property
Helps protect the place where you do business - whether you own it, lease it, or work out of your home. Also covers personal property (such as tools and equipment) used in your business. Much like the property coverage you have for your home, business property insurance helps protect the place where you do business and its contents. Did you know? Most homeowner policies don’t cover damage or accidents related to business done from your home.
General Liability
General Liability
Helps protect your business from claims or lawsuits involving your products or business operations. Imagine the impact to your business if a customer is injured at your workplace or an employee causes damage to a customer’s property. General liability can cover all that plus claims of false advertising and libel. Did you know? General liability insurance does not cover lawsuits relating to your professional services.
Professional Liability
Professional Liability
Professional liability coverage can help reduce the risk to your business if you are sued for a professional error.
Workers' Compensation
Workers' Compensation
Provides benefits to your employees for work-related injuries or illnesses including medical care, wages from lost work time and more. If the worker's family decides to sue you, coverage can help you with related legal fees. Why do you need workers' compensation coverage? First, most states -- and many of your customers -- require it. Plus, it’s the right thing to do for your employees. For a one-person operation, work-related injuries may not be covered by your health insurance.
When would you like your coverage to start?
*
Date Format: MM slash DD slash YYYY
If you currently have business insurance, when does your current policy end? (optional)
Date Format: MM slash DD slash YYYY
Details about your operations
Does your business lease any of your employees to other companies or businesses on a permanent or temporary basis?
*
Yes
No
Does your business lease any employees from a PEO (Professional Employment Organization)?
*
Yes
No
Business Location
Registered Business Name
*
Your registered business name is the one that you use for legal or tax purposes. Example: Joe's Italian Pizza, LLP (registered business name) vs. Joe's Pizza (name the company does business as everyday).
DBA if applicable
What is the name that you do business as every day? This could be the name over your door, on your website, or printed on your business cards.
Business Address
*
Enter your primary business address -- the place where you do most of your work -- even if it is your home. This will help us calculate an accurate cost.
Street Address
Address Line 2
City
State
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
Zip Code
Mailing Address
*
Same as previous
Street Address
Address Line 2
City
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
Contact Information
Name
*
First
Last
Phone
*
What's the best number to reach you at if we have questions regarding your quote?
Email
We respect your privacy and won't share your email address with anyone else.
Enter Email
Confirm Email
Your Business
Legal Entity
*
-- Select --
Association
Corporation
Individual / Sole Proprietor
Join Venture
Limited Liability Company (LLC)
Limited Liability Partnership (LLP)
Partnership
Professional Corporation (PC)
S Corporation
Year Business Established
*
(YYYY)
Website Address (optional)
Tell us about what your business does — the product you manufacture, the goods you sell and/or the services you provide.
*
Where do you work?
*
-- Select --
Home Office
Commercial Building
Commercial Condo
Do you own or rent your business location?
*
Rent
Own
Estimated Annual Sales or Gross Revenue
*
This is the amount of pre-tax income you estimate your business will generate from the sales of products or services you provide for the 12-month period this policy would be in effect.
Gross Revenue for the Last Fiscal Year
*
This is the amount of pre-tax income your business generated from the sales of products or services you provided for the prior fiscal year.
Estimated Annual Gross Payroll for the Next 12 months
*
This is the amount of pre-tax payroll your business pays to employees (excluding owners)
What percent of your sales do you estimate will come from the internet?
*
Estimate for the 12-month period this policy would be in effect.
Property Coverage
Number of Property Losses in past 3 years
*
A property loss could include damage to your place of business or the things inside it like furniture, equipment, tools or fixtures. It could also involve theft of business property. A loss is a single incidence of damage or theft—such as a storm, fire or robbery. It is NOT the number of items damaged or stolen.
Business Personal Property Limit
*
This is the total replacement value of your business contents. If you turned your building upside down and shook it, everything that falls out is what you'll want to include in this total.
Personal Property of Others Limit (Optional)
Include any items housed or stored at your business location that belong to your customers. Examples could include shoes or computers left in a shop for repairs. If the value of these items changes over time, enter the maximum value of customer property you have on hand at any given time.
Tenants Improvements and Betterments Limit (Optional)
Include the total value of any changes or improvements you made to your leased property in order to do business there. This could include any brand-related enhancements, equipment or permanent fixtures installed to run your business. Provide the replacement (not original) costs of any enhancements you made in the past or plan to make while your policy is in effect.
General Liability Coverage
Number of Liability losses in past 3 years
*
A general liability loss could include damage to property you're responsible for, and accidents or injuries that occur while conducting business. If you are interested in professional liability or hired and non-owned auto coverage, then include those losses in your total.
Business Liability Limit (Each Occurrence / Aggregate)
*
1,000,000/2,000,000
500,000/1,000,000
2,000,000/4,000,000
A general liability loss can include damage caused by you and/or your employees while doing business. It can also include accidents or injuries that happen at your workplace. Select the amount of coverage you would like for each individual claim along with a total for all the claims in a given policy term. Should you require other limits - use comments field at the end of the application.
Do you offer a benefits plan to your employees?
*
Yes
No
Employee benefits plans include health insurance, 401Ks, and any other benefits you offer employees.
Professional Liability Coverage
Average Years of Professional Experience for Principals
*
This is the number of years of experience, on average, the principals in your company have in their field. For example, in a legal firm, if 5 principals have 20 years of combined experience working in law, the answer would be 4 years. A principal is typically the owner(s) of the business.
Building Information
Year Built (YYYY)
*
Is your building constructed with wood framed exterior walls?
*
Yes
No
The 'framing' of a wall is the structure that is required for support. Sometimes called 'studs' or '2x4's.Typically residential buildings are constructed with wood framed walls.
Number of Floors
*
Does your building have an indoor sprinkler system?
*
Yes
No
Approximate square footage that your business occupies (Sq.Ft.)
*
You can measure to get this, or if you are a leasee, you can check your lease documentation.
Workers' Compensation insurance
How long have you had Workers' Compensation insurance?
*
-- Select --
No Prior Insurance
1 year
2 years
3 or more years
Is the business non-profit?
*
Yes
No
How many employees do you have
*
Do you want to cover your company owners by this Workers Comp. insurance?
*
Yes
No
Federal Employer's ID Number
*
Comments Section
Comments (optional)
Provide any additional comments, such as other limits needed, or additional coverage you're looking for, such as Sex Abuse and Molestation.
X
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