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call 914-381-2040
and speak with
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A.J.Benet Home > Online Quotes > Business Insurance Quote Request

BUSINESS
INSURANCE
QUOTE

  

We would like to provide you with a free, no-obligation business insurance quote. Please provide as much information possible for the most accurate quote. This information will be kept confidential and will be used for quote purposes only.
 

General Information

Name of Business:

Contact Name:

Address:

City:

  State:   Zip:

Business Phone:

  Fax:

Best Time To Call:

  AM   PM

Contact Email Address:


Current Insurance Information

Company Name (not agency):

Policy Expiration Date:

  Premium Amount: $

What type of coverages do you currently have:

Bond
Commercial Auto
Commercial Liability
Commercial Property

Commercial Umbrella
Directors & Officers Liability
Disability
Group Health

Group Life
Professional Liability
Workers' Compensation
Other  


About Your Business

# of full-time
employees

# of part-time
employees

How long
in business

How many
locations

Annual
sales

years

$

Please give a brief description of your business and clientel (below):


Coverage Information

Please select the type of coverages you want:

Bond
Commercial Auto
Commercial Liability
Commercial Property

Commercial Umbrella
Directors & Officers Liability
Disability
Group Health

Group Life
Professional Liability
Workers' Compensation
Other  


Additional Comments

Please give any additional comments you feel appropriate for this quotation. If you have additional information where there was not enough space, please enter them here.


Please click on the "Submit Quote" button to send your quote request.
One of our representatives will respond to your submission as soon as possible.

   

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A. J. Benet, Inc. • 430 Center Avenue • Mamaroneck, NY 10543 • Customer Service: 914-381-2040 • Sales: 914-381-0177 • Fax: 914-381-5089

Important Note: This website provides only a simplified description of coverages and is not a statement of contract. Coverage may not apply in all states.
For complete details of coverages, conditions, limits and losses not covered, be sure to read the policy, including all endorsements.

©2012 A.J. Benet, Inc. Insurance