Commercial Short Form | Oklahoma Insurance Group

Contact

Your Name *

Email *

Cell Phone *

Best Method To Contact *

PhoneEmailSMS/MMS

The business

Type of Risk *

Name of Business *

Business Legal Structure *

FEIN

# Of Years In Trade *

Estimated Annual Sales *

Employee Payroll *

Annual Subcontractor Expense *

Business Address Info *

My home, business and mailing addresses are all the same.My business address is also my mailing address.My business address and mailing address are different.

Business Address *

What Insurance Company Are You With Now (If New Business just put New Below) *

Current Annual or Monthly Cost (Put $0 If New) *

I’d Like To Start This On: *

Have You Submitted This Quote To Any Other Agents? *

YesNo

Tell Us About Your Business and What All You Do *

What Is The Biggest Issue You Are Facing? *

Coverage

Tell Us What Coverage Do You Need *

General Liability OnlyGeneral Liability w/tools (Most companies can do a nice tool rider for 20-30 per month)General Liability plus building and tools (You own your building and need coverage for it plus tools)Work Comp (Owner only or for Employees)Commercial Auto (Auto and Trailers)Equipment Schedule (Coverage for dozers, skid steers, scaffolding and other heavy equipment)UmbrellaBonds (We can do them all)

Source

How did you find our agency? *