Request a Worker’s Comp Quote

 

Get a Free Worker’s Compensation Quote!

Our agents are standing by and ready to help. We can find you the right insurance at just the right price!

No Additional Fees

Unlike most insurance agencies, we charge no additional agency fees for filling out or processing insurance forms, down payments, monthly renewals or reinstatement of insurance. We will only charge a NSF (Non-Sufficient Funds) fee if your check is returned from your financial institution for insufficient funds.

Where To Find Codes & Payroll Information On A Policy

Below is a sample policy. The circles indicate where to find your Codes & Payroll Amount

Workers Comp Code location

 

Insurance Type : *
Name : *
Email : *
Phone : *
FAX # :
Address:
Payroll listed on current policy for 1st class Code:

If more than one Class Code, please list additional Codes & Payroll for Code:

Additional Code:
Payroll for Code:
Additional Code 2:
Payroll for Code 2:
Years in Business:*
Description of company operations:*
Any losses in the last three years:*
If YES, please explain:
Do you have a formal safety program in operation:
If YES, briefly describe:
Current Insurance Provider (Ins. Company, not Agent):
If Other, please enter name:
Years Worker's Comp policy in force?
Recaptcha Word Verification: