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Home » Specialty Areas » Contractor Insurance » Contractor Insurance Quick Quote Request Form

Contractor Insurance Quick Quote Request Form

Please fill in the form below or call us at 1-800-622-7370 for your FREE, no-obligation Contractors Insurance Quote.

NOTE: For Builders Risk/Course of Construction Insurance – use this link for an Instant Online Builders Risk Quote (Available in all states except HI and AK).

General Liability and Workers Compensation

Available only in DC, FL, GA, IN, MD, MS, NC, PA, SC, TN, VA
Home builders, remodlers, and light commercial general contractors must have $250,000 in annual sales to qualify for the program.
Trade contractors must have at least two full time employees to qualify for program.

Contact Information
Applicant Name:*
Full Legal Name of Business:*
Business Entity Type:
Location Address:*
Street Address Address Line 2 City State ZIP Code
Is Your Mailing Address Different Than Your Location Address?
- No
- Yes
Mailing Address:*
Street Address Address Line 2 City State ZIP Code
Email:*
Website:
Facebook URL:
Daytime Phone:*
Cell Phone:
Why Are You Requesting A Quote Today?*
CAPTCHA
Operations
Type of Contractor:*
Please provide several sentences to describe in detail your operations and typical jobs.*
Years Of Operation Under Current Business Name:*
If none, please enter 0.
Years Of Experience By Owner(s) In This Field:*
If none, please enter 0.
% of Work Residential:*
% of Work Commercial:*
Estimated Annual Gross Sales:*
Do You Have Employees Other Than Owners?*
- Yes
- No
Do You Use Uninsured Subcontractors?*
- Yes
- No
Do You Use Insured Subcontractors?*
- Yes
- No
Owners
Name*
Work Description
Estimated Annual Payroll*
Example: John Smith
Executive Supervisor
$45,000
W-2 Employees Who Are Not Owners
Please enter "none" in all 3 boxes on the first line if there are no W-2 employees who are not owners.
Work Description*
# of Employees*
Estimated Annual Payroll*
Example: Framing
3
$80,000
1099 Uninsured Subcontractors
Work Description/Classification*
Estimated Annual Amounts Paid*
Example: Land Clearing
$110,000
Insured Subcontractors
Estimated Annual Amounts Paid To All Insured Subcontractors Combined*
If none, please enter "none" in the field.
Types of Policies To Be Quoted
General Liability*
- Yes
- No
Current General Liability Carrier:
Current General Liability Premium:
Workers' Compensation:*
- Yes
- No
Current Workers' Compensation Carrier:
Current Workers' Compensation Premium:
Builders Risk:*
- Yes
- No
Current Builders Risk Carrier:
Current Builders Risk Premium:
Auto:*
- Yes
- No
Current Auto Carrier:
Current Auto Premium:
Property:*
- Yes
- No
Current Property Carrier:
Current Property Premium:
Equipment:*
- Yes
- No
Current Equipment Carrier:
Current Equipment Premium:
Insurance & Loss History
Any policy been cancelled or non renewed in past 3 years?*
- Yes
- No
If yes, please explain policy type and reason:
Losses under any policy in past 3 years?*
- Yes
- No
If yes, please explain policy type, give brief description of claim, approximate date, and amount paid:
Comments:
Once you hit submit, your web form will be reviewed by an experienced contractor insurance specialist who will review your application and will be in touch if additional information is needed. In many cases, a proposal may be offered during the next business day.

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3014 Devine St.
PO Box 5866
Columbia, SC 29250
1-800-622-7370 Toll Free
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1-803-256-4017 Fax
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