Business Insurance Quote

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Current Coverages *
 YesNo
Bond
Commercial Auto
Commercial Liability
Commercial Property
Commercial Umbrella
Directors & Officers Liability
Disability
Group Health
Group Life
Professional Liability
Workers Compensation
Other
Business Information
 Please Answer the Following Questions
# of Full-Time Employees
# of Part-Time Employees
How long in Business
# of Locations
Property/Premises Information
 Please Answer the Following Questions
Address
Occupancy Owner/Tenant
Year Built
% Occupied
Sprinklers Yes/No
Construction Type
Stories
# of Basements
Square Footage
Burglar Alarm yes/no
Building Value $
Contents
General Insurance Information
 Please answer the following questions
Annual Gross Sales
Before Taxes
Annualized Payroll $
Cost of Subcontracted Work
 $300,000$500,000$1,000,000$2,000,000
Limits Requested

Disclaimer Notice - The premiums quoted are estimates based on information you provided. This quotation does not constitute a contract of insurance, nor does it provide coverage for any loss or claim. Further information may be required in order for a complete quote to be provided. This quote request contains some information about coverage offered but it does not list all of the conditions and exclusions that apply to the described coverage. The actual wording of the policy governs all situations.

This is not an “Application” for insurance.  We ask that you provide general quote request information on this online form for the purposes of gathering general information on your interest in our insurance products and services.  A Marshall & Sterling representative will be in contact with you shortly to discuss the formal application process.