General Liability Quote Request

General liability responds when someone outside your business claims your operations injured them or damaged their property. Landlords, general contractors and clients routinely require proof of it before you can start work.

Fill in what you know and leave the rest blank — only your name, email and phone are required. We will come back to you for anything missing. Nothing here is an application and nothing is binding.

What General Liability covers

Your business Business Name

DBA / Trading AsOnly if different from the name above.Business Structure

Business Address

CityZIP Code

Mailing AddressOnly if your mail goes somewhere else.

Your First NameYour Last Name

Email AddressPhone Number

Years in BusinessApproximate Annual RevenueA rough figure is fine.

WebsiteIf you have one.

What your business does Describe Your Operations, Products or Services

Do You Operate From This Location Only?

If No, List Your Other Locations

Do You Hire Subcontractors?

If Yes, What Work Do They Do?

Do You Collect Insurance Certificates From Them?

Size and exposure

Full-Time EmployeesPart-Time Employees

Total Annual PayrollEstimated Annual Sales / Receipts

Square Footage You OccupyDo You Own or Lease the Premises?

Do Customers or the Public Come On Site?Is Any Alcohol Sold or Served?

Any Products You Sell, Make or Distribute? Any Work You Perform Away From Your Premises?

The cover you want

Cover Limits You WantPer claim and total for the year. Leave blank and we will recommend.Does a Contract Require You to Add Someone to Your Policy?

If Yes, Who?Is a Waiver of Subrogation Required?A clause stopping your insurer recovering costs from the other party. Your contract will say if you need it.

Your current cover and timing Any liability claims in the past 5 years?

Current or Previous InsurerIf you are switching or renewing.What You Pay NowIf you know it.

When Do You Need Cover to Start?

Anything Else We Should Know

This is a solicitation for insurance. Completing this form does not apply for or bind cover. Coverage cannot be bound or changed via this form, e-mail, voicemail, text, or facsimile — only by written confirmation from our office.

Would you rather fill it in on paper?

Download the same questions as a printable form, or as a Word file you can type into, and bring it in or send it back to us.

PDF version · Word version · All quote request forms

Would you rather fill it in on paper?

Rather just talk it through?