Virginia Commercial Insurance Quote
For Help, Please Call 804-288-7312
Fields marked (*) are mandatory.
Name of Business*
Address of Business*
City*
State
VA
Zip Code
County
Business Phone
Email
Do you own or lease space in your building?
Own
Lease
No Locations
Describe your business
Number of years in business
Number of full-time employees
Number of part-time employees
Number of commercial insurance claims over the past 5 years:
Do you currently have commercial insurance coverage?
Policy ends on
January
February
March
April
May
June
July
August
September
October
November
December
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Coverage Limits
Building Coverage (If necessary)
Contents Coverage, If Needed
(equipment, tools, inventory, supplies, etc.)
Liability Limits
Please select
$300,000/$600,000
$500,000/$1,000,000
$1,000,000/$2,000,000
Deductible
Please select
$500
$1,000
$2,500
$5,000
Miscellaneous Information:
Additional Comments:
Contact Name
Business Type
Please select
Individual
Corporation
Partnership
Other
Are other coverage needed?
Workers Compensation
Yes
No
Commercial Auto
Yes
No
Commercial Umbrella
Yes
No
By submitting this information, I understand that Virginia Insurance Group may contact me via e-mail, phone or fax, using the information I have supplied, to provide quotes or to obtain additional information needed to provide quotes.
Where permitted by law, some insurance companies may confirm your information, through the use of reports which may include driving record and credit score.
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