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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




  Business Name


  Street Address (Not PO Box)






  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
Group Health
Group Life
Professional Liability
Workers' Compensation

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

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

Limits Requested

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

  Liability Limits Requested




  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.