Business Insurance Quote Request | Check My Insurance Rate

Step 1 of 6

How can we reach you?

We’ll contact you if a quote needs more information.

First name * Last name * Mobile phone * Email *

Step 2 of 6

Tell us about your business

Everyday language is perfect.

Legal business name * DBA / trade name (if different) Business structure Street address * City * State * ZIP code * Years in business Website or business social page What does your business do? *

Step 3 of 6

A few details about your work

Estimates are fine for now.

Estimated annual gross revenue * Number of employees (excluding owners) * Number of owners Annual employee payroll (if any) Do you use subcontractors? Where do you perform work?

About your subcontractors

Estimated annual subcontractor cost Do they provide proof of insurance?

Step 4 of 6

What would you like us to review?

Select all that apply. It’s okay if you’re unsure.

Coverage options *

General Liability Business Property / BOP Commercial Auto Workers’ Compensation Professional Liability / E&O Cyber Liability Umbrella / Excess Not sure — help me decide

Business property

Do you own or lease your space? Approximate value of business contents/equipment

Business vehicles

How many vehicles? Primary vehicle use

Employees

What kind of work do your employees perform?

Professional services

What advice or professional services do you provide?

Technology and customer information

Do you store customer payment or sensitive personal information?

Additional liability limits

Has anyone requested a specific liability limit?

Step 5 of 6

Current insurance and timing

Do you currently have business insurance? When would you like coverage to start?

Your current policy

Current insurance company Policy expiration date

Any claims or losses in the last five years? * Briefly describe the claim(s) Anything else we should know? Helpful documents (optional): current policy, declarations page, loss runs, contract, or other files Up to 5 files, 5 MB each (15 MB total). PDF, JPG, PNG, DOC, or DOCX.

Step 6 of 6

Review your request

Check the details before sending. Coverage is not effective until confirmed by an authorized agent or insurer.

By submitting, you ask Check My Insurance Rate to contact you about this request. This form is not an application for binding coverage.