Business Quote Form

General Info
Contact Name *
Contact Name
Phone *
Lines of Business Proposed *
What type of work do you do? Explain.
Expiration Date
Expiration Date
How many years have you been in business?
Who is your current insurance carrier? Please include how many years you have been insured with them as well.
If you own the building that you are in, how much coverage would you like on it?
How much coverage would you like on your business personal property?
How much coverage would you like for additional property items such as signs, lights, clocks, fences, playgrounds, etc.
This deductible would apply to both your building and/or your business personal property.
Physical Address *
Physical Address
What is the total amount of square footage in the building?
What is the amount of square footage that you inhabit within the building?
Please list the other tenants within your building (if any)
How old is the roof on the your building?
If your business came to a sudden hault tomorrow due to a total loss (ie: a fire), how much money would you need over a twelve month time frame in order to keep your business running until your building was rebuilt?
If your sump-pump fails, or sewage backs up through your sewers and drains, you'll need to add this coverage by endorsement if you would like coverage. This is standard throughout the industry.
While many insurance agents are not aware of this, coverage for computer hardware and software are excluded underneath the business personal property form and must be added separately underneath the Electronic Data Processing (EDP) form. This is standard across the industry.
There is a different way to cover the tools that leave your company's premises and are taken onto the job site. And by "tools," we're referring to hand tools that are valued at $1,000 or less per item. How much coverage (if any) would you like a quote for on this?
This is basically the same concept as above, except that we're referring to items that are over $1,000 in value when we are referring to "Equipment" that is taken off premise and onto the job site.
An installation floater is an insurance policy that covers personal property installed, fabricated or erected by a contractor. It covers the property until the installation work is accepted by the purchaser or when the insured's interest in the property installed ceases. For example, assume I'm a carpenter and I've purchased cabinets to install for a client's kitchen. If these cabinets were stolen out of my truck before they were installed, I would have no coverage unless I had an installation floater endorsement on my policy. Is this coverage is desired, how much coverage would you like?
This insurance protects the employer from financial loss due to the fraudulent activities of an employee or group of employees. The loss can be the result of the employee's theft of money, securities or other property of the employer.
General Liability
One way that insurance carriers rate your general liability premium is based upon annual sales. Please list your annual sales (ie: $4,000,000) and "subdivide" them per line items as well if possible ($500,000 for office employees, $300,000 for salespersons, $250,000 for window installation, etc.)
Some insurance carriers rate your general liability premium off of your annual payroll. Please list your annual payroll, and break it down into specific classifications once again ($500,000 annual payroll, $200,000 paid to office employees, $200,000 paid to construction employees, etc.) If you'd like to get more technical, the RiG team is always willing to conduct a "pre-quote audit" and show you some tricks as to how we can reduce your premium in doing so.
Please list the total number of employee within your business. Please also further "subdivide" this number into specific categories as well (10 total employees, 5 clerical, 3 construction, 2 sales...).
Workers Compensation
An experience modification, commonly called an “e-mod,” is an important factor used to adjust your work comp premium. Experience modifiers are calculated by organizations known as "rating bureaus" and rely on information reported by insurance companies. The rating bureau used by most states is the NCCI, the National Council on Compensation Insurance.
An owner of a business has the option to exclude themselves from their Work Comp coverage and thus save some money on their premiums. If you would like to take this option, please list each owner, their annual payroll, and the type of work they are specifically engaged in (ie: office work, sales, in the field, etc.)
Please list each classification along with its corresponding payroll. For example, you may have a "clerical" classification for your office employees with a corresponding payroll of $100,000, or a "salespersons" classification for your sales force with a payroll of $50,000.
Commercial Auto
Please list the year, make, model, and VIN for each vehicle that you would like coverage for. Please also indicate which vehicles should have full coverage (collision & comp deductibles) and which should have liability only.
If your car is damaged or destroyed in an accident, collision insurance coverage will typically pay to fix or replace it. Types of covered accidents include hitting another car or hitting a stationary object, like a bridge or a tree.
With Comprehensive coverage, your insurance company pays for damage to your auto caused by an event other than a collision, such as fire, theft or vandalism. If you hit an animal, or if your auto is flooded or stolen, Comprehensive coverage will apply.
Non-owned and hired automobile liability insurance covers bodily injury and property damage caused by a vehicle you hire (including rented or borrowed vehicles) or caused by non-owned vehicles (vehicles owned by others, including vehicles owned by your employees).
Commercial Umbrella
A business umbrella policy picks up where your business auto liability, general liability or other liability coverage stops. Umbrella insurance is an inexpensive way to provide extra coverage against bodily injury and/or property damage.
Is there anything else that you would like us to know?