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Get Started – Business Insurance Quotes

KIS Insurance services, LLC makes shopping for business insurance easy. Fill out a short, easy form and license agent will contact you.

Required fields are marked with: *

Business name :
Number of full-time employees:
Number of part-time employees:
Will this replace an existing business policy?
Contact's First Name :
Contact's Last Name :
Business Street Address :
(No P.O. Boxes) Suite or Unit # :
City
State :
ZIP Code :
Is the address above also the garaging address? :
Legal Entity/Status :
Number of Years in Business :
Gross Annual Payroll :
Gross Annual Revenue :
Years of Owner Experience within Industry:
Brief description of the business :
Desired Amount of General Liability Coverage:
Business Hours:
To Select Additional Coverage Types to Discuss with the Agent:
(No P.O. Boxes) Suite or Unit #:
City :
State :
ZIP Code :
Year Built or Last Updates Completed :
Construction Type :
Number of Stories :
Total Square Footage of Building :
Square Footage of Space Occupied by this Business :
Burglar Alarm Type:
Fire Alarm Type:
Desired Deductible Amount:
Physical Building Coverage Limit :
Business Personal Property Amount:
Additional Properties to Insure?
Select Additional Coverage Types to Discuss with the Agent:
Do you have a safety program?
Street Address of Garaging Location:
Suite or Unit #:
City :
State :
ZIP Code :
Number of Vehicles :
Number of Drivers :
Maximum distance traveled to a delivery or worksite :
Miles Desired Commercial Auto Liability Limit :
Desired Uninsured/Underinsured Motorist Limit :
Desired Deductible :
Select Additional Coverage Types to Discuss with the Agent :
Current Insurance Company :
Current Annual Premium :
Number of Claims in the Past 3 Years :
How many years has the business been continuously insured? :
Desired Effective Date:
Business Street Address:
Suite or Unit #:
City :
State :
ZIP Code :
Contact's E-mail Address :
Contact's Phone Number :
 

 

 

 

 

 

 

 

 

 

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