Walker Insurance Services, a leading independent personal insurance & commercial insurance lines agency in Texas.

Insure with Walker!                               Save with Walker!                              Tell your friends! HOMEOWNERS INSURANCE QUOTE AUTO INSURANCE QUOTE COMMERCIAL INSURANCE QUOTE LIFE INSURANCE QUOTE HEALTH INSURANCE QUOTE OTHER INSURANCE QUOTES
             
  
   Home
   About Us
   Home & Auto
   Commercial
   Life/Health
   Full Product List
   Customer Service
   Contact Us
   Privacy Policy

TRAVELERS
Southwest Region
"AGENCY OF
THE YEAR"
AWARD WINNER

HARTFORD
National
"TOP PERSONAL
LINES AGENCY"
AWARD WINNER

America First
TOP PRODUCING AGENCY
 

Commercial Insurance Quote Request

Thanks for completing this 5-Minute Quick Form!
 We look forward to providing quotes with the best company, coverage and premium!

If you like, you can also call us to request a quote over the phone.

No coverage is bound until you are contacted by one of our representatives.
Concerned about privacy?  We are a secure site and will respect your privacy
and safeguard your personal information.  Check out our Privacy Policy.

First  Name  
Last Name  
Business Name  
Type Of Business  
Street Address  
Street Address  
City, County, State, Zip  
Phone #'s    Work    Cell
Your web site
(if applicable)		  
E-mail     It is OK to save my
  email address for the purpose of current and future correspondence*: Yes  No
    How did your hear about Walker Insurance?  
 
Business Activities
Type of organization:   
Federal Tax ID Number (Or SS# if no tax ID):  
How many owners, partners, or officers?  
How many employees, excluding owners, partners or officers?  
Are you just starting this business?   Yes   No
In what year did you start this business?  
How many years experience in your industry?  
Last year's payroll (excluding owners):  
This year's projected payroll (excluding owners):  
Estimated annual contract labor cost:  
Last year's gross sales:  
This year's projected sales:  
Describe your normal business activities:   
Do you currently hold a commercial insurance policy of any kind?  Yes   No    If yes:
   Your current commercial insurance company(s): 
   Your current policy expiration date(s):               
   The type(s) of coverage you currently carry:        
Have you had losses or claims in the past 5 years?  Yes   No
If yes, please give description, date and amount paid for each:
Do you office in:  A commercial building?   A home office?
  If you office in a commercial building, do you rent or own the building?   Rent   Own
What approx. amount of square footage do you occupy for business purposes? 
What is the approximate age of the building? 
What is the predominant exterior building material of the building? 
Do you use a monitored alarm system in your place of business?  Yes   No
 
 Coverage Selection
 Please indicate the desired coverage you would like quoted.
  General Liability  How much?:   Commercial Auto
  Excess Liability  How much?:   Property
  Workers Comp   Equipment
  Builder's Risk   Directors and Officers Liability
  Professional E & O   Group Health    Individual Health
  Business life insurance    Other:
 Desired effective date: ASAP   Other:
 Are you looking for coverage to satisfy a client contract requirement?  Yes  No
 
 Comments
 


*Concerned about privacy?  We are a secure site and will respect your privacy and safeguard your personal information.
Check out our Privacy Policy.

 

 

At Walker Insurance Services, we are proud to offer quotes for the lowest prices, discount premiums and best rates that you are looking for!
We are a leading independent personal lines & commercial lines agency.

Verhagen, Glendenning & Walker, LLP, dba Walker Insurance Services
Verhagen, Glendenning & Walker, LLP, dba VGW, LLP
Copyright 2003-2007