Business Insurance Quote in San Antonio, TX | My Insurance Group

Commercial Insurance Quote Request

Thank you for the opportunity to earn your business!

The form below will allow us to efficiently gather the information we need to get started on your quote request. In order to complete the form, you will need information such as your business' gross sales, payroll figures, tax ID number and cannot save your progress. So, if you do not have this info handy, please gather it and come back later.

If you prefer to speak with one of our commercial insurance specialists, please call: (210) 708-3203

"*" indicates required fields

Step 1 of 7

14%

General Business Information

Business Legal Name*

DBA (if applicable)

Organization Type*

Contact Person's Name*

First Last

Contact Phone Number*

Contact Email*

Contact Person's Job Title*

Business Website Address

FEIN*

DO NOT enter SSN. If no FEIN, enter 123456789.

Primary Location Address*

Street Address City State ZIP Code

Mailing address:*

Same

Different

Mailing Address*

Street Address City State ZIP Code

What coverage is your business interested in?*

General Liability

Commercial Property

Commercial Auto

Cyber Liability

Worker's Comp

Professional Liability / Errors & Omission (E&O)

Excess Liability / Umbrella

Inland Marine (Builder's Risk / Contractor's Equipment / Installation Floater / Cargo)

Garage Liability / Garage Keepers

Check all that apply

Does the business perform any work as a contractor?*

If your business is in the construction industry (ie Remodeling, carpentry, painting, drywall, electrical, plumbing, HVAC, etc), please check 'Yes'

Yes

Do you have any contract requirements that need to be met with these policies (i.e. certain coverages or limits of liability)?*

If yes, you will be given the opportunity to upload a copy of the contract requirement later in the application process.

Yes

Artisan Contractor Questions

Contractor Type*

Please select the contractor type that best fits your business. On the next page, you can describe in more detail.

Do you have an active contractor's license?*

Yes

Type of license:*

License Number:*

Commercial Work %*

Please enter a number less than or equal to 100.

Residential Work %*

Please enter a number less than or equal to 100.

New Construction %*

Please enter a number less than or equal to 100.

Remodel %*

Please enter a number less than or equal to 100.

Any work above 15ft or below 1ft surface?*

Yes - Work above 15ft

Yes - Work below 1ft underground

How often do you use a written contract with your customers?

Always

Sometimes

Never

Do you preform any Tract Home work?*

Work in any subdivision for a home builder with more than 20 homes?

Additional Business Information

Description of business operations:*

Please provide a brief description of your business operation to help understand all of your operations.

Year Business Started*

Years of Industry Experience*

Number of Owners*

Number of staffed locations:*

Occupied Sq ft:*

Est. Annual Gross Sales/Revenue*

Number of Employees*

Estimated Annual Payroll*

Include owners/officers in WC coverage?*

Yes

List all NAICS/SIC codes for any type of work your employees do for you

If you don't know the NAICS/SIC codes, please describe as best you can the type of work your employees do you. Please also breakdown the percentage of your payroll for each class/code.

Class Code (or Type of Work)

Percentage of Payroll

Are subcontractors used?*

Yes

Subcontractor Questions

Does your subcontractor agreement include a hold harmless clause?*

Yes

Do you require subcontractors to maintain General Liability Insurance matching your limits of liability?*

Yes

Do you generally use the same subcontractors?*

Yes

Est. annual cost of subcontractors (incl. materials & labor)*

Give a brief description of the work typically subbed out:*

Auto Liability Section

Do you have a DOT# / MC# or plan to get one in the next 6 months?*

Yes

DOT #*

If unavailable or not applicable, enter: "N/A"

MC #*

If unavailable or not applicable, enter: "N/A"

What is the average driving radius for your business?*

Please enter the average driving distance from your garaging address for the owned vehicles.

Average number of jobsite visited daily*

Please enter the average number of jobsites visited by your vehicles on a daily basis.

Are any vehicles used in the business leased?*

Yes

Please list the type of cargo being carried and percentage:*

Example: "Raw Construction Materials / 30%" Use the "+" to add more lines as needed.

Auto Liability Limit:*

Uninsured/Under-insured Motorist Coverage*

Do Not Include

Include

Limit Requested*

Personal Injury Protection*

Do Not Include

Include

Limit Requested*

Filings Required*

Yes

Filing Type*

Hired/Non-owned Auto Required*

Do Note Include

Include

Limit Requested*

Cargo Coverage Requested*

Do Not Include

Include

Limit Requested*

Trailer Interchange Required*

Do Not Include

Include

# of Trailers*

Roadside Assistance*

Do Not Include

Include

Current GL/BOP policy in force:*

Yes

Interested in Telematics Discount*

Yes

Any additional coverage notes, requests, requirements

How would you like to provide the driver list?*

Enter drivers now

Email list of drivers to you

How would you like to provide the vehicle list?*

Enter vehicles now

Email list of vehicles to you

Drivers Information

Driver's Name / TXDL # / DOB/ Marital Status / Date of Hire / Yr of CDL Endorsement*

Vehicle/Trailer Information

Year / Make / Model / VIN / Value

Current Insurance

Does the business currently have insurance?*

Yes

Have you had any claims or judgments filed against you in the last 5 years?*

Yes

Please provide a brief description of the circumstances surrounding the claim/judgement against you:*

Be sure to include the date of loss, any amounts paid by you or the carrier and the current status of the claim/judgement (open/closed).

Current Insurance Company:*

Expiration Date:*

Expiring Premium:*

Please upload a copy of your current insurance declarations:

Drop files here or

Max. file size: 5 MB.

Loss Run Reports*

Do you agree to help us obtain a copy of your current loss run history report showing any losses/claims for the last 5 years?

Yes

File upload

Please upload any contract requirements that you need met with these policies so that we are quoting appropriately.

Drop files here or

Max. file size: 5 MB.

Why are you shopping for insurance?*

Please check all the apply

New Venture

Price

Bad Claims Experience

Poor Customer Service Experience

No local representation

How did you first hear about us?*

Current Customer

Family/Friend Referral

Channel Partner Referral (Mortgage Broker, Realtor, Other Insurance agent)

Google Search

Social Media Post (Facebook, Instagram, Twitter)

Local Event

Other

Consent*

I consent & agree to the following:

The application information is true and correct to the best of my knowledge.

By submitting this request you are authorizing My Insurance Group, its affiliates and carrier partners the access to pull the necessary reports (i.e. claims, credit, and loss history) to confirm the data submitted.

Submitting your quote request does not constitute a binding confirmation of a new or revised insurance coverage.

My Insurance Group is committed to respecting your privacy and communication preferences. So that we may remain compliant with state and federal regulations, we need your expressed permission to communicate with you through phone, text and email as needed.

You may opt-out of all future communication at any time by making your preferences known to us.

CAPTCHA