Below is a list of just a few of the workers comp. we can place.
Apartments/Condominiums
Attorneys Professional 
Aviation
Bars/Taverns
Bookkeepers
Broadcaster Media Liability
Buses
Casino/Gaming Risks
Catering Trucks
Chemical Manufacturers and Distributors
Civil Engineers
Commercial General Liability
Computer software development
Condominiums
Construction
Contractors
Contractors including Residential Builders and Developers
Courier/Messenger Services
Court Clerks/Recorders/Reporters
Crime Coverage
Data Processing 
Doctors staff
Emergency Medical Technicians
Employment Agencies
Employment Practices
Engineers Professionals
Environmental Engineers/Testing
Environmental Service
Executive Search Firms
Exercise & Sport Clubs
Food Delivery/Perishables/Manufactured
Food Products
Fortune 500 and 1000 Accounts
Garment Workers
General Partnership Liability
Healthcare Facilities
High Value Dwellings
HIV Testing/Consulting Services
Home Inspection
Hotel & Motel Programs
Insurance Agents/Brokers
Internet 
Labs
Limousine/Black Car Services
Logging Operations Liability
Long Term Care Insurance
Loss Control Consultants E&O
Lumber/ Building Materials
Managed Healthcare
Management Consulting Services
Manufacturers & Contractors
Manufacturing Industries
Mechanical Engineers
Mercantile Related Operations
Motels Umbrella Liability
Municipalities Program
Notary Public
Pest Control Advisors
Petrochemical Exposures
Pizza Delivery Services
Plastics Manufacturers
Property Owners/ Managers
Public Officials
Public Officials
Publishers
Real Estate Agents & Brokers
Residential Care Providers
Resort Properties
Restaurants
Security services armed/unarmed
Shopping Malls and Centers
Sightseeing Buses 
Staffing Agencies
Truckers
Wholesale Distribution
and many more..........

We value your PRIVACY. Any information obtained will ONLY  be used to provide you a quote. Your data will remain private and will not be used for any other purpose.

Business Name:  

Sole Proprietor/Individual  Partnership     Corp.     LLC. 
or  other

Your Name:   
Address:  
City:  
State:  
Zip Code:  
E-Mail:  
Phone:  
Fax: 
   
Please describe the  type of services your company provides.
Years in Business  
Years of Business Experience
Number of employees: 
Gross Annual Payroll 
(not including owners)
Tax Id #,  Fein or 
Social Security
Are you currently insured? Yes     No
If yes, please provide below information
if yes,
-Carriers Name
-Yrs with current carrier.

Comments or Remarks:

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