General Liability Insurance Quote

Business Name (not required)

Address *

Estimated Gross Sales *

Estimated Payroll (not required)

# of Employees (not required)

Years in Business (not required)

Years of experience (not required)

When does your insurance expire? (not required)

Business Class Code *

Tire shop: do you sell new and/or used tires? (check all that apply) (not required)

New tires Used tires We do not sell tires (repair/service only)

About what percent of tire sales are USED tires? (not required)

Do you offer MOBILE tire service (at the customer's location or roadside)? (not required)

Yes No

Hours of operation for the MOBILE service (days and times, e.g. Mon-Sat 8am-6pm, 24/7 roadside) (not required)

How many service trucks/vans are used for mobile service? (not required)

Do you want us to quote the mobile service vehicle(s) too? (not required)

Yes No

Liability requesting *

Do you work on residential homes/structures larger than 5,000 sq ft? (Work on homes over 5,000 sq ft is EXCLUDED unless the Residential Project/Structure Size Restriction Exclusion is bought back) (not required)

Yes - I work on homes over 5,000 sq ft No - all residential work is 5,000 sq ft or under Commercial work only - no residential

Residential Project/Structure Size Restriction Exclusion buyback - which limit would you like quoted? (not required)

$50,000 $100,000 $250,000

Would you also like a quote for: (not required)

Workers Compensation (WC) Tools & Equipment (Inland Marine)

Owner's Payroll Annually (not required)

W-2 Employee Payroll Annually (not required)

Owner-Only / Ghost Policy? (no employees - a certificate to satisfy contract requirements) (not required)

Yes - owner only, no employees No - I have employees

Do you hire Subcontractors (1099) (not required)

Yes No

1099 Subcontractor Payments Annually (enter 0 if none) (not required)

Total value of small hand and power tools (items under $1,500 each) $ (not required)

What kind of jobs is the equipment used on? *

Do you rent or lease equipment from others? (not required)

Yes No

If you rent or lease equipment: typical value you have at one time $ (leave blank if none) (not required)

Is equipment ever left at a job site unattended? *

Yes No

How is the equipment secured at the job site and overnight? (not required)

Radius of operation (how far from home base, in miles) (not required)

Is any of the equipment tagged for road use? (not required)

Yes No

Deductible you prefer (not required)

Do you have coverage for this now? *

Yes No

Who is it with now? (not required)

When does that policy expire? (not required)

Any losses or claims in the past 3 years? (not required)

Yes No

Description of operations (not required)

When do you want your policy to start? *

How would you like us to contact you? (not required)

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📋 General Liability Insurance Quote Details

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