Skip to the content
Insurance
Auto, Home & Personal Insurance
Auto Insurance
Homeowners Insurance
Renters Insurance
Motorcycle Insurance
Boat & Marine Insurance
- View All Personal
Business Insurance
Business Owners Package Insurance
Commercial Auto Insurance
Commercial Property Insurance
General Liability Insurance
Workers’ Compensation Insurance
- View All Business
Life & Health Insurance
Individual Life Insurance
Individual & Family Health Insurance
Final Expense Insurance
- View All Life and Health
I Am...
An Individual or Family
Single Adults
Married Couples With Children
Empty Nesters
– View All
Our History
Meet Our Staff
Our Insurance Carriers
Insurance Blog
Support
Online Billing & Payments
File A Claim
Auto ID Card Request
Certificate of Insurance Request
Policy Change Request
Insurance Resources
Contact Us
Shippensburg Office
Secure Contact Form
Refer a Friend
Get A Quote
Home
>
Business Insurance Checklist
Business Insurance Checklist
General Information
Name
*
Legal Name of Business
Business Phone
*
Email
*
Business Address
Street Address
Address Line 2
City
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
Insurance Needs
Choose Lines of Insurance You Are Interested In
Commercial Auto
Aviation
Business Interruption
Commercial Property
Commercial Liability
Contractor General Liability
Hotel/Motel
Liquor
Medical Malpractice
Office Pkg/Prof. Liability
Product Liability (E&O)
Restaurant
Special Events
Workers' Compensation
Other
Other (Please Explain)
Current Insurance Information
Insurance Company Name (Not Agency Name)
Premium Amount
Years Insured
Policy Expiration Date
MM slash DD slash YYYY
About Your Business
Number of Employees
Number of Locations
Years in Business
Annual Sales
Detailed Description of Your Business
Additional Comments or Questions
Email
This field is for validation purposes and should be left unchanged.
Δ
See How Our Independent Insurance Agency Benefits You
See How Our Independent Insurance Agency Benefits You
Get a Quote