On-Line Contractor General Liability Quote Form

Request a contractor’s general liability insurance quote from us. We will deliver it fast and on budget. You want us to grab the bull by the horns and get it done for you, affordable, quality coverage and most of all hassle free. We make buying liability insurance so easy. Minnesota contractors and small businesses benefit by our experience and fast certificates. How much can you save? Provide some basic info and we will tell you. We work directly with the Department of Labor & Industries and provide them 100’s of general liability insurance certificates annually. Now offering quotes in 5 upper Midwest states: Minnesota, MN, Wisconsin, WI, Iowa, IA, North Dakota, ND and South Dakota, SD. We write roofers, drywall, masonry contractors, HVAC, janitorial, painting, plumbers, electricians, carpentry, handyman, snow plowing, landscaping, carpenters and many more. We also write subcontractors, home builders, general contractors & paper contractors. We provide hassle free and headache free contractors insurance quotes & low down payments. Use our simple one-page form below, it only takes a minute.

Contractors Business Information

Enter your full name:

Company name:

Street address:

City:

State:

Zip Code:

Email (required):

E-Mail again for accuracy:

Phone:

Fax (optional):

Business Underwriting Information

Type of Contracting Operation:

Please describe exactly what you do:

Business Type (sole proprietorship, corporation, LLC, etc.):

License Number:

Social Sec. or Employer ID#:

Limit of Liability Coverage Requested?

Currently Insured?

Name of Carrier & how long insured?

Prior Claims?

Describe claims in detail:

Years in business:

Years experience in field:

Percentage of work residential:

Percentage of work commercial:

Number of Active Owners:

Number of Employees:

Annual Employee Payroll: $

Annual Gross Sales: $

Do you subcontract work?

(If yes, what percentage of your work is subbed, and what kind of work?)

Do you do foundation work?

Do you work on condos?

Employees paid over $18/hour?

Do you have a safety program?

Comments/Remarks:

Send my insurance quotation via :
EmailFaxRegular MailCall me by phone

Thank you for filling out this form COMPLETELY!

We value your input as PRIVATE information. Every step has been taken to insure your privacy, security, and our intent is to release quote information only to you. We will not give your data to ANY other person or group for sales, marketing, or ANY other purposes. By checking the box below you agree to allow our agency to release this information via the method you have chosen, and to release them from any liability should this information be accidentally viewed by others. Our intention is to maintain your complete privacy.

Yes, I Agree. Please Send Me a Quote NOW!
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