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contractor insurance Contractor & General Liability Insurance:
We specialize in Contractor Liability, and other Business General Liability Insurance. Get a Quote today!

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workers comp insurance Workers Compensation Plans:
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Commercial Tool Floater
Insurance Quote Form
One Simple Form - takes only 2-3 Minutes!


Your Name: (REQUIRED)
Business Name: (REQUIRED)
Property Address: (REQUIRED)
City: (REQUIRED)
State: MUST be California!
Zip/Postal:(REQUIRED)
E-Mail (REQUIRED):
E-Mail
(again for accuracy):
Phone: (REQUIRED)
Fax (optional):
Building/office Square footage:
Occupancy: Owner Tenant
   
Occupancy Type:
(describe entities & and number of units, such as "4 unit apartment" or "2 offices and barber shop", etc.)
   
Number of stories: One Two
  Three 4 or more
   
# of feet to nearest fire hydrant:
# of miles to nearest fire station:
   
Currently Insured? Yes No
   
Name of Carrier & how long insured?
   
Prior Claims? Yes No
     
Describe claims in detail:
   
Coverages:
Tool Coverage Amount   Other Property Amount
Describe Tools/Property
Deductible $
($250, $500, $1,000, etc.)
   
Other Coverage/Remarks
(describe any extra coverages needed such as business interruption, robbery, computers, etc.):
   
Send my quotation via: E-Mail Fax
  Regular Mail
  Call Me by Phone
   
Thank you for filling out this form COMPLETELY!

We value your input as PRIVATE information. Every step has been taken to insure your privacy, security, and our intent is to release quote information only to you. We will not give your data to ANY other person or group for sales, marketing, or ANY other purposes. By checking the box below you agree to allow our agency to release this information via the method you have chosen, and to release us from any liability should this information be accidentally viewed by others. Our intention is to maintain your complete privacy.

Yes, I Agree. Please Send Me a
Commercial Insurance Quote NOW!
   

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A service of PHD Insurance Brokers, Inc. - 12966 Euclid Street, Suite 495
Garden Grove, CA 92840 - Phone: 714-534-6310 - Fax: 714-534-2943
Email: info@phdinsurancebrokers.com - CA LICENSE # 0462338

 
     

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