General Liability Insurance

General liability insurance, often referred to as business liability insurance, is coverage that can protect you from a variety of claims including bodily injury, property damage, personal injury and others that can arise from your business operations.

Please complete the form below for a general liability insurance quote

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Start Date for Insurance

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Current Insurance Company

Company Name

Owner's Name

First Name

Last Name

Type of License

Phone

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Email Address

Company Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Website

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Year Business Started

Years Experience in Industry

FEIN

Number of Owners

Number of Full Time Employees (Excluding Owners)

Number of Part Time Employees (Excluding Owners)

Annual Payroll (Excluding Owners)

Annual Gross Sales

Requested Coverage Limits

Percent of Work New Construction

Percent of Work Remodel or Repair

Description of Business

Do You perform any out of state work?

Percent of Work Commercial

Percent of Work Residential

Do You Trim Trees

Do You Spray Paint

Do You work on Mobile/Manufactured Homes

Do You Use Sub Contractors?

Sub Contractor Payroll Per Year

Do you need additional Insured's?

Have you had any claims in the last 5 years?

Describe any claims you have had

Does applicant perform any roofing, roof work, or any activity of any kind on any roof, including any construction, repair, maintenance, cleaning or inspection of any roof?

In the last 10 years, have you had a construction defect claim for your current business or any previous business?

Do you now or have you ever acted as a General Contractor?

Do you ever hire day labor?

Has any insurance carrier cancelled, declined, or non renewed the risk in the past 3 years?

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General Liability

General Liability Insurance

Please complete the form below for a general liability insurance quote

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