Get Business Insurance Quote For Your Business GET STARTED Business type and start date What kind of work does your business do? * How is your business structured? * Ownership structure: Corporation Estate Joint Venture Limited Liability Company Not for Profit Corporation Partnership Sole Proprietor Professional Association Trust Other When would you like your coverage to begin? * Select a start date: MM DD YYYY BUSINESS INFO Tell us a little more about your business and your policy needs. For the next 12 months, estimate the following: * First Name Last Name Do you use your first and last name as your business name? * Yes No Business Name If you use your name as your business name, leave this blank. Phone Number * (###) ### #### Email * Your company's website http:// Describe your business Tell us about the products you make, goods you sell, or services you provide. How many losses have you claimed in the last 3 years? * What is your Federal Employer ID Number (FEIN)? Approximately when did your business begin? * MM DD YYYY Do you have a DBA or FKA business name? DBA (Doing Business As) FKA (Formerly Known As) Neither DBA/FKA Name Do you currently have an insurance policy in effect for the coverage requested? Yes No Prefer not to answer LOCATION Primary Business Location Address Line 1 * Address Line 2 City * State * Zip Code * Country * PRODUCTS What kind of coverage do you need? Select Coverage * General Liability - The basic protection for claims against your business. Professional Liability - Protection in the event of a lawsuit against your business for performing services negligently, even if it's not your mistake. Business Owners Policy - General Liability plus coverage for your business property. Cyber Security - Protection for your data and all cyber-related security risks. Agriculture Insurance - Protects against loss of or damage to agricultural land, crops, or livestock. Aggregate limit * This is the total amount we will pay for damages, claim expenses, and supplemental payments during the policy. $250K $500K $1M Deductible * The amount you must pay out of pocket before your insurance begins to cover costs. $1K $5K $10K $15K $20K $25K COVERAGE QUESTIONS For the next 12 months, estimate the following for your business: Payroll for officers? * Includes salaries, bonuses, commissions and overtime for executive officers. $ Payroll for non-officers? * Includes salaries, bonuses, commissions and overtime. Include full-time, part-time, and temporary staff, but not executive officers or independent contractors. $ Expected revenue? * Include sales, commissions, and other sources of revenue. $ How many executive officers do you have? * If you are an officer include yourself here. Not counting officers, how many employees do you have? * If you are not an officer, include yourself here. Do not include sub-contractors. Is your business operated out of your home? * Yes No Approximately how many square feet does your business occupy? * If you work from your home, how much space is dedicated to your business? Does your business own and need coverage for the building? Include Do not include Do you conduct annual training for your employees with respect to privacy matters? * Privacy matters refers to failure to protect sensitive information, including subsequent actions by a regulator. Yes No Is your business compliant with the Payment Card Industry Data Security Standard (PCI-DSS) * Yes No Not Applicable Owner/Officer Name * Estimated Annual Payroll * $ Payroll Provider Leave blank if you do not have a payroll provider. Does your business provide any of the following products? Check all that apply * Alcoholic beverages or products (includes serving, selling or sub-contracting) Animal/livestock feed Any products requiring a prescription Baby food Energy drinks Kava None of the above Does your business provide any of the following operations or services? Check all that apply. * Commercial farming Companies/operations not in compliance with county, state and federal food and safety regulations Delivery outside of catering services Grocery stores or supermarkets Health coaching Importers - produce or dairy making up more than 20% of total sales Importers - seafood, meat, poultry Nutrition consulting None of the above Thank you, check your email. We will contact you soon with a quote.
