Confidential Quote Request Form

Please complete this form for your confidential quote. Information provided will be used for your insurance purposes only.

Business Entity Type*
If currently insured, what type of coverage does the organization have?
Do you have an employment handbook?*
Do you use an employment application for every potential employee?*
Do you have an "At Will" provision in the employment application or handbook?*
Have you implemented an anti-sexual harassment policy?*
Do you use outside employment counsel for employment advise?*
Is Internet Liability desired?*
Does the church own the building?*
Are there Monitored Alarm and/or Security Systems on site?*
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