Commercial Insurance Quote

Commercial Insurance Intake

Tell us about your business so we can find the right coverage at the right price.

1Basics

2Contact

3Business

4Coverage

5Details

6Claims

7Documents

8Finish

Tell us about your business

This takes about 8 to 10 minutes. You can stop and pick it back up later.

Business name(Required)

Industry(Required)

Pick the closest match. If none fit, choose Other.

Describe your industry(Required)

Where are you today?(Required)

New business or startup

Currently insured

Previously insured, coverage lapsed

How soon do you need coverage?(Required)

Immediately

Within 30 days

30 to 90 days

At my renewal date

Just comparing options

Current policy renewal date

If you have more than one policy, use the one renewing soonest.

Current insurance carrier(s)

Approximate total annual premium

How to reach you

Your name(Required)

First Last

Your title or role

Owner, office manager, CFO, etc.

Email(Required)

Phone(Required)

Best way to reach you(Required)

Phone call

Text

Best time to reach you

Mornings, after 3 pm, Tuesdays, etc.

Mailing address(Required)

Street Address Address Line 2 City State ZIP Code

Is your business address the same as your mailing address?(Required)

Yes

Business address(Required)

Street Address Address Line 2 City State ZIP Code

Do you operate from more than one location?(Required)

Yes

How many locations in total?(Required)

Business profile

Legal entity type(Required)

Year the business started(Required)

Website

Describe the products or services you offer(Required)

Two or three sentences in your own words. Who are your customers and what do you do for them?

Full-time employees(Required)

Enter 0 if none.

Part-time employees(Required)

Enter 0 if none.

1099 contractors you use regularly(Required)

Enter 0 if none.

Estimated annual payroll(Required)

Annual gross revenue(Required)

Do you own or lease your building?(Required)

Own

Lease

Work from home

Mobile, no fixed location

Does a contract, landlord, or customer require you to carry specific coverage?(Required)

Yes

Not sure

Common examples: a lease that requires $1 million liability, or a general contractor that requires workers’ comp.

What do they require?

Paste the insurance section of the contract or lease if you have it. You can also upload the document later.

What coverage are you looking for?

For each line, tell us whether you want a quote, already have it, or are not interested. Not sure what something means? Each line has a short description and a link to examples.

We list everything we can place so nothing gets overlooked. Marking a line Not interested just means we won’t quote it right now. You can change your mind at any time. Open the full coverage guide in a new tab.

General liability(Required)

Want a quote

Already have this

Not interested

Covers injury or property damage you cause to other people. Nearly every business needs this and most leases and contracts require it. Examples

Commercial property(Required)

Want a quote

Already have this

Not interested

Covers a building you own against fire, wind, theft, and similar losses. Examples

Business personal property (contents)(Required)

Want a quote

Already have this

Not interested

Covers the equipment, inventory, furniture, and tools inside your space, whether you own or lease the building. Examples

Business owner's policy (BOP)(Required)

Want a quote

Already have this

Not interested

A bundle of general liability plus property for smaller businesses. Often the cheapest way to get both. Examples

Professional liability / errors and omissions(Required)

Want a quote

Already have this

Not interested

Covers claims that your advice, design, or service was wrong and cost a client money. Examples

Cyber liability(Required)

Want a quote

Already have this

Not interested

Covers data breaches, ransomware, and funds lost to email fraud, plus the cost to notify customers. Examples

Commercial auto(Required)

Want a quote

Already have this

Not interested

Covers vehicles titled to the business. Personal auto policies usually exclude business use. Examples

Hired and non-owned auto(Required)

Want a quote

Already have this

Not interested

Covers accidents when employees drive their own cars or a rental for work. Examples

Workers' compensation(Required)

Want a quote

Already have this

Not interested

Pays medical bills and lost wages for employees hurt on the job. Required in South Carolina with four or more employees, and many contracts require it regardless. Examples

Inland marine / tools and equipment(Required)

Want a quote

Already have this

Not interested

Covers tools, equipment, and materials that move around, on trucks, on job sites, or in transit. Examples

Umbrella / excess liability(Required)

Want a quote

Already have this

Not interested

Adds extra limits above your liability, auto, and workers’ comp policies for large claims. Examples

Commercial flood(Required)

Want a quote

Already have this

Not interested

Flood is excluded from property policies. This covers rising water damage to the building and contents. Examples

Employment practices liability (EPLI)(Required)

Want a quote

Already have this

Not interested

Covers claims from employees for wrongful termination, discrimination, or harassment. Examples

Directors and officers (D&O)(Required)

Want a quote

Already have this

Not interested

Covers the personal liability of owners, board members, and officers for management decisions. Examples

Business income / interruption(Required)

Want a quote

Already have this

Not interested

Replaces lost income and pays ongoing bills while you are shut down after a covered loss. Examples

Liquor liability(Required)

Want a quote

Already have this

Not interested

Covers claims tied to serving or selling alcohol. Required if you serve. Examples

Pollution / environmental(Required)

Want a quote

Already have this

Not interested

Covers cleanup and third-party claims from spills, fumes, mold, or contamination. Examples

Builders risk(Required)

Want a quote

Already have this

Not interested

Covers a building while it is under construction or major renovation. Examples

Surety and license bonds(Required)

Want a quote

Already have this

Not interested

Bonds required by the state, a licensing board, or a project owner to guarantee performance or compliance. Examples

Group health / employee benefits(Required)

Want a quote

Already have this

Not interested

Health, dental, vision, and life plans for your employees. Examples

Key person life(Required)

Want a quote

Already have this

Not interested

Life insurance on an owner or key employee that pays the business if they die. Examples

I’m not sure what I need. Please review my answers and advise me.

A few more details

These questions only appear based on the coverage you chose.

Vehicles

How many vehicles does the business own or lease?(Required)

Vehicle types

Cars / SUVs

Pickups and vans

Box trucks

Trucks over 26,000 lbs

Trailers

Typical driving radius(Required)

Local, under 50 miles

Regional, 50 to 200 miles

Long haul, over 200 miles

Do any drivers hold a CDL?(Required)

Yes

Workers’ compensation

What kind of work do your employees do?(Required)

List each type of job and roughly how many people do it. Example: 3 office staff, 6 field technicians, 1 sales.

Do you know your experience modification (mod) factor?(Required)

Yes

Never heard of it

If yes, we’ll ask for it on the call. A mod above 1.0 usually means you are overpaying.

Building and contents

Building construction(Required)

Year built

Square footage you occupy(Required)

Sprinkler system?(Required)

Yes

Not sure

Alarm system?(Required)

Central station (monitored)

Local alarm only

None

Estimated value of your contents and equipment(Required)

Data and professional services

Do you store customer personal, financial, or health data?(Required)

Yes

Not sure

Do you accept credit cards?(Required)

Yes

Any data breach, hack, or wire fraud in the past 5 years?(Required)

Yes

Contractors

Do you use subcontractors?(Required)

Never

Sometimes

Regularly

Do you collect certificates of insurance from subcontractors?(Required)

Always

Sometimes

About what percent of your work is subcontracted?

Alcohol sales

About what percent of sales come from alcohol?(Required)

Flood

Do you know your flood zone?(Required)

Yes, high risk (A or V zone)

Yes, low or moderate risk (X zone)

Any flood damage at this location in the past 10 years?(Required)

Yes

Not sure

Claims history

Carriers price on claims history, so honest answers here help you. Please note: to quote most commercial policies we will need loss runs, a report of claims for the past 5 years. Your current carrier or agent is required to give you this within a few days of a written request. If you’d like, we’ll send you a one-line email you can forward to them, or handle the request for you with a Letter of Authority.

Any insurance claims in the past 5 years?(Required)

Yes

List each claim(Required)

Date (month/year)

Type (auto, injury, property, etc.)

Amount paid (approx.)

Open or closed?

Click the plus sign to add another row.

Has any policy been cancelled or non-renewed by a carrier in the past 5 years?(Required)

Yes

Please explain(Required)

Would you like help requesting your loss runs?(Required)

Yes, send me the email to forward

Yes, request them for me

No, I’ll get them

Upload documents

Optional now, but the fastest way to get an accurate quote. Everything uploads over an encrypted connection.

Declarations pages are the first one or two pages of each policy. They show your carrier, policy number, coverages, limits, and premium. Upload one for every policy you have. Photos from your phone are fine.

Current declarations pages

Drop files here or

Accepted file types: pdf, jpg, jpeg, png, heic, doc, docx, Max. file size: 10 MB, Max. files: 10.

PDF or photos. Up to 10 files, 10 MB each.

Loss runs, contracts, lease, or anything else useful

Drop files here or

Accepted file types: pdf, jpg, jpeg, png, heic, doc, docx, xlsx, Max. file size: 10 MB, Max. files: 10.

Optional.

Almost done

Carriers need the items below to set up a quote. They are stored securely and are not sent by email.

Owner or principal's full legal name(Required)

Owner or principal's date of birth(Required)

Federal EIN(Required)

Format 12-3456789. Sole proprietors without an EIN may enter N/A.

Any bankruptcy, tax lien, or judgment against the business or owner in the past 7 years?(Required)

Yes

Some carriers ask. It rarely blocks coverage.

Review and acknowledge

Accuracy(Required)

The information I’ve provided is true and complete to the best of my knowledge. I understand this is a request for quotes, not an application for insurance, and no coverage is in place until a policy is issued and payment is made.

Coverage offered(Required)

I understand that every coverage listed on this form has been offered to me by Safe Harbor Insurance Advisors, LLC. For any coverage I marked “Not interested,” I am choosing not to request a quote at this time, and I understand my business may not be protected for those types of losses.

Contact and privacy(Required)

I agree to be contacted by Safe Harbor Insurance Advisors by phone, text, or email about this request, and I have read the privacy notice. I may opt out at any time.

Type your full name as your signature(Required)

You’ll receive a PDF copy of this summary to sign electronically.

Date(Required)

Please complete the form below for a quote.

What areas are you interested in our guidance?*
- Business Owners Policy - Protecting your business
- Workers Comp - Compliance & Protecting Employees
- Commercial Auto - Business Vehicles
- Cyber Insurance - Protect from Cyber Losses
- Professional Liability - Being Sued for your Guidance
- Commercial Buildings - Protect your Assets
- Commercial Umbrella - Threat of Lawsuits
- Errors & Omissions - What if you make a mistake
- Inland Marine - Protect your equipment
- Other
Primary Policyholder Name*
First Last
Email*
Business Name
Website
Your Phone Number*

How did you find our agency?*
- Google Search
- Facebook Page/Post
- Facebook/Instagram Ad
- Google Ad
- Customer Referral
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Who referred you to us?
Name of your Current Insurance Provider
Upload your current Declaration Pages
Max. file size: 5 MB.

Uploading your current declaration pages gives our advisors much of the information we need to run your proposal through all of our carriers.
Anticipated Start Date*
Please tell us more about your business and how we can help you.
hCaptcha*

Request Your Proposal Here

Are you ready to save time, aggravation, and money? The team at Safe Harbor Insurance Advisors is here and ready to make the process as painless as possible. We look forward to meeting you!

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