Business Insurance Quote

 
Current Insurance Company...
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Current Coverages *
 

Business Information
 Please Answer the Following Questions
# of Full-Time Employees
# of Part-Time Employees
How long in Business
# of Locations
Brief Description of business
& Clientele

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/Other Property

Insurance Information
 Please Answer the Following Questions
Annual Gross Sales
(before taxes)
# of Employees
Annualized Payroll
Cost of Subcontracted Work
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.