Business Insurance

As an independent Broker of Commercial Insurance, we will take your information provided below out to the insurance marketplace and negotiate multiple quotes from Underwriters who specialize in your industry. Prime Business Insurance Group will provide multiple policy options and place them side by side on a summary to help you make the best-informed decision regarding coverages, deductibles, limits, payment options, etc.

Submit your business information below and we will begin immediately. Include copies of your current policies and previously completed applications to shorten the process and reduce the amount of information requested from you.

* Indicates required field

Company Name as filed with the State *

DBA or Other Named Insureds? *

Contact Name *

First

Last

Contact Email *

Contact Phone Number *

Website for Business *

Type of Organization: LLC, Inc, Sole Prop? *

Physical Address for Company *

Mailing Address for Company *

FEIN # or SSN# *

Ownership % Breakdown *

Date Business Started under this name? *

# of years the owner has been in this business? *

Estimated Annual Payroll Estimate? *

Total # of Employees - Full Time & Part Time *

VERY Detailed Description of Business: *

Estimated Annual Sales Estimate? *

Upload Copies of Current Policies *

Max file size: 20MB

Upload Any Previous Insurance Applications Completed *

Max file size: 20MB

Any Additional Comments *

Submit