Business /Commercial / Contractor Insurance    1-888-822-2400 Business Insurance and Contractor Insurance Specialists. We work with you to get the right insurance coverage for your business or project. • Damage to vehicle • Loss of income • Liability exposure resulting from operation of business • Theft, robbery, or employee dishonesty We offer to our clients the following products: • Fire for buildings and contents • General Liability with Contractor Iinsurance a speciality • Business Automobile • Systems Breakdown • Crime • Business Interruption • Excess/Umbrella Liability • Workers Compensation • NYS Disability • Director & Officers • Employment Practices Liability • Long Term Disability General Information Name: Street Address: City, State, Zip: Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho llinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Phone: Ex: 1-555-555-5555 Email: Type of Business: Choose one... Contractor Building Office Retail Service Other Liability Renewal Date: mm/dd/yy Current Liability Insurance Company: Contact At Your Office For Insurance: Workers Comp Renewal Date: mm/dd/yy Type of Contractor: Number of Owners: Number Of Employees: Employee's Estimated Annual Payroll:

Your business cannot afford to be without business insurance. If you are a contractor it is especially important due to the nature of your work and the many different contractor insurance products that are out there. We know the business insurance and contractor insurance markets and can get you the coverage you need at the best possible price. We are a family company with the clout of a huge concern, having lasting relationships with the best contractor insurance and business insurance providers in the country. We don't pressure you, we simply show you what we can do for your business and let the bottom line be your guide.