Conveniently located on 135 in Greenwood, Indiana.We are just a phone call away at:
(317) 884-1000
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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. Coverage can only be bound by an agent with a signed application and down payment.
Business Quote
General Information
Contact Name:
Choice 1
Choice 1
Business Information
# of Full-Time Employees:
# of Part-Time Employees:
How long in Business? (yes):
How many locations?:
Please give a brief description of your
business and clientele:
Property/Premises Information
Current Insurance Company
Company Name:
Policy Expiration Date:
(not agency)
Current Insurance Coverages
Current Coverages
Yes
No
Yes
No
Bond
Commercial Auto
Yes
No
Yes
No
Commercial Liability
Commercial Property
Yes
No
Yes
No
Commercial Umbrella
Directors & Officers Liability
Yes
No
Yes
No
Disability
Group Health
Yes
No
Yes
No
Group Life
Professional Liability
Yes
No
Workers Compensation
Other
Address:
Occupancy Status:
Year Built:
% Occupied:
Sprinklers:
Construction Type:
Stories:
# Basements:
Sq. Footage:
Burglar Alarm:
Building Value:
Contents:
Other Property (Specify):
Owner
Tenant
Yes
No
Please Choose
Frame
Brick Veneer
Stucco
Metal
Concret
Yes
No
Insurance Information
Other:
Annual Gross Sales (before taxes):
Number of Employees:
Annualized Payroll:
Cost of any Subcontracted Work:
Limits Requested:
$300,000
$500,000
$1,000,000
$2,000,000
Describe any claims you've had
in the past 5 years:
Additional Comments:
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Home
Auto
For Your Home
Life
Commercial
Our Team
Request a Quote
Contact Us