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Home > Business Commercial > Contractors Liability Quote Request
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Contractors Liability Quote Request


Thank you for your interest in securing an individualized liability quote for your business. In order to provide this quote we will need the following additional information to customize a liability quote for you. Please fill out all fields as completely as possible.

Business Name *
E-Mail Address *
First Name *
Last Name *
Street *
City *
State *
ZIP / Postal Code *
Primary Phone Number *
How many years have you been in business? *
How many years do you have in this trade? *
Desired Limit of Liability *
Desired Deductible *
Additional Insureds Needed?

Waivers of Subrogation Needed?

Expected Gross Receipts *
# Active Partners, Owners, Directors, Officers *
# Clerical Employees and Payroll *
# Sales Employees and Payroll *
# Other Employees and Payroll *
Are you involved in the building of any new single-family houses including residential condominiums, multi-unit homes, tract housing, subdivisions, townhouses, or apartment buildings? *
Do you ever use workers from any daily labor pools or other alternative staffing firms, other than a PEO?

Do you have any knowledge of an occurence that could result in a claim?

Have you ever been named in a construction defect claim or suit?

Have you ever declared bankruptcy or had a judgment entered against you? (does not apply if caused solely by medical expenses)

Do any directors, partners, or officers have a prior felony conviction? (other than a solely drug-related charge at least 10 years old)

Do you have all required licenses and permits for all work to be performed under this insurance?

Submission Validation
Required

Important Notice
Any submissions or payments made via this website do not constitute a binding agreement to your policy or coverages. Changes and payments to policies are not effective or binding until you, or any party involved, receive official notice from either your insurance agent, or your insurance company. If you have any questions, please feel free to contact us.

Per the terms of our online privacy policy we will not resell your information to any third-party.
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Adcock-Adcock Insurance Agency
315 W. Fletcher Ave Tampa, FL 33612 | Driving Directions
Office: (813) 933-6691 | Toll Free: (866) 933-6691 |  Fax: (813) 932-6287
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