Durkin & DeVries Insurance Agency Commercial Quotation

For a Commercial insurance quote simply fill out the form below and click the submit button. One of our agents will contact you to review a personalized quote within 24 hours. If you have any questions regarding this form or regarding coverage in general, please feel free to contact us.

Personal Info

First Name:

Last Name:

Business Name :

Address :

City:

State:

Zip Code:

E-mail:

Telephone:

Fax:

Best time to call:

Current Insurance Information

Your curent Insurance Company?
(not agency):

Expiration Date?:

Preium Amount?:

What type of coverages do you currently have:

Bond
Commercial Auto
Commercial Liability
Commercial Property

Commercial Umbrella
Directors & Officers Liability
Disability
Group Health

Group Life
Professional Liability
Workers' Compensation
Other

About Your Business

The number of full-time employees?

The number of part-time employees?

How long have you been in business?

How many locations do you have?

What are your annual sales?

Please give us a brief description of your business:

Coverage Selection

Please select the type of coverage(s) you are interested in:

What type of coverages are you interested in?:

Bond
Commercial Auto
Commercial Liability
Commercial Property

Commercial Umbrella
Directors & Officers Liability
Disability
Group Health

Group Life
Professional Liability
Workers' Compensation
Other

Coments

Please give us any comments you feel appropriate for this quotation. If you have additional information where there was not enough space, please enter it here:

Submitting an insurance quotation request to Durkin & DeVries Insurance does not constitute a binding confirmation of new or altered insurance coverage. Verbal or written confirmation must be obtained from Durkin & DeVries Insurance to confirm binding or altering coverage.