Workers Compensation Quote

Complete the details below to get your free workers compensation insurance quote

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Business Name *

Contact Name *

Phone Number *

Location Address *

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City

State

Zip Code

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Mailing Address *

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City

State

Zip Code

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Legal Entity *

Year Established *

EIN# or Social Security# *

Partner/Owners *

Owner Payroll *

Do you wish to Exclude Owners? *

Full-Time Employees *

Part-Time Employees *

Total Employee Annual Payroll *

Sub-Contractors *

Total Sub-Contractors Annual Payroll *

Annual Sales *

Current Class Codes – if known *

Desired Effective Date *

Current Carrier *

Expiration Date *

Please describe the nature of your Business *

Claims

Any Claims in the last 5 years? *

Date/Loss Amount *

Loss Details (Area) *

Date/Loss Amount (C2) *

Loss Details - Area (C2) *

What types(s) of business insurance are you interested in?

Additional Comments *

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California Licensed # 6003600 | Oregon Licensed # 3001117035 | Washington Licensed # 1083606 Arizona Licensed # 3001419877 | Texas Licensed # 2812176

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Phone: (888) 570-1058
Fax: (916) 290-7210
Email:
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Agency Mailing Address
333 University Ave
Suite 200
Sacramento CA, 95610

Agency Hours:
Monday – Friday: 9:00am to 5:00pm
Saturday & Sunday: Closed

Sacramento, CA Office

333 University Ave
Suite 200
Sacramento, CA 95825

Tacoma, WA Office

1201 Pacific Avenue
Suite 600
Tacoma WA, 98402

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