Commercial LiabilityQuote Request Form Business Name Address Province British Columbia Ontario Alberta City Postal Code Contact First Name Contact Last Name Contact Phone Contact Email Date the Business Started What industry is the business in? How many years experience do you have in this industry? Provide a brief explanation of operations. How many full-time staff do you have? How many part-time staff do you have? What is the expected payroll this year? What was the gross revenue last year? What is the expected revenue this year? What percentage of your sales is from the USA? What percentage of your sales is from other parts of the globe? Please break-down where your revenue comes from based on good or services offered Do you carry out work through written contracts with every client? Yes No Do you accept liability on behalf of a third-party? Yes No Is the delivery of your good or service time critical? Yes No If so, please explain. Do you hire contractors to complete work? Yes No If so, are they required to have their own insurance? Yes No How many physical locations does the business have? Does it own any of these locations? Yes No If so, do you need commercial property quoted as well? Yes No What amount of liability would you like? $1M $2M $3M $5M $10M What deductible would you like? $500 $1,000 $2,500 $5,000 Do you have office supplies or equipment you want coverage for? Yes No If so, please explain. ›» SUBMIT