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1-214-351-4097

2626 Cole Ave Suite 300

Dallas, TX 74204

9:00 am - 6:00 pm

Mon - Fri

Insurance Plus Of Texas

Commercial Insurance Quote
One Simple Form - takes only 2-3 Minutes!  

Need Help?   Phone 214-351-4097


     Insured Information                                                                                                 

 
                                                                *  Required Field

General Information

  Contact Name

*

  Email

*

  Business Name

*

  Street Address (Not PO Box)

*

  City  

*

  State

*

  County *

  Zip

*

  County

*

  Business Phone

*

Current Insurance Company

  Company Name
  Policy Expiration Date

Current Insurance Coverage

  Current Coverage None
Commercial Auto
Commercial Liability
Commercial Property
Commercial Umbrella
Directors & Officers Liability
Disability
Group Health
Group Life
Professional Liability
Workers' Compensation
Other 

Business Information

  # of Full-Time Employees            *
  # of Part-Time Employees           *
  How long in Business? (yrs) *
  How many locations?  

  Please give a brief description of your  business and Clientele

*

Only fill this portion if you need property coverage. If No property coverage is required skip to next Section

Property/Premises Information

  Address
  Occupancy Status Owner  Tenant
  Year Built
  % Occupied
  Sprinklers Yes  No
  Construction Type
  Stories
  # Basements
  Sq. Footage
  Burglar Alarm Yes  No
  Building Value
  Contents
  Other Property (specify)

Limits Requested

  Annual Gross Sales: (before taxes)      *
  Annualized Payroll              *
  Percent of work Subcontracted *

  Liability Limits Requested

 

*

$300,000
$500,000
$1,000,000
$2,000,000

  Describe any claims you've had in the

  past 5 years

Additional Comments, information. You may   also ask questions in this box.

Disclaimer Notice - The premiums quoted are estimates based on information you provided. If you have question or other pertinent information you feel is necessary to properly quote your Insurance, Please feel free to call our office for a personalized free quote.