Dansard-Little Agency

Business Quote

General Information
Contact Name *
Email *

Business Name
Address
City
State
Zip
County
Business Phone
Fax
Current Insurance Company
(not agency)
Company Name
Policy Expiration Date
Current Insurance Coverages
Current Coverages Bond
Commercial Auto
Commercial Liability
Commercial Property
Commercial Umbrella
Directors & Officers Liability
Disability
Group Health
Group Life
Professional Liability
Workers' Compensation
Other
Business Information
# of Full-Time Employees
# of Part-Time Employees
How long in Business? (yrs)
How many locations?
Please give a brief description of your business and clientele
Property/Premises Information
Address
Occupancy Status Owner  Tenant
Year Built
% Occupied
Sprinklers Yes  No
Construction Type
Stories
# Basements
Sq. Footage
Burglar Alarm Yes  No
Building Value
Contents
Other Property (specify)
Insurance Information
Other
Annual Gross Sales: (before taxes)
Number of Employees
Annualized Payroll
Cost of any Subcontracted Work
Limits Requested $300,000
$500,000
$1,000,000
$2,000,000
Describe any claims you've had in the past 5 years
Additional Comments
* = Required Field
Disclaimer Notice - The premiums quoted are estimates based on information you provided. This quotation does not constitute a contract of insurance, nor does it provide coverage for any loss or claim. Coverage can only be bound by an agent with a signed application and a down payment.

DLittle Update

 15621 S. Telegraph Rd
Monroe, MI 48161
phone: (734) 241-1133 
Fax: (734) 241-9275

Monday through Friday
8:30am-5:00pm
 
CLICK FOR A QUOTE

 


Are you renting a car? Click here!







Facebook

Dansard-Little Insurance Facebook Page

Insurance News

Tue, 17 Oct 2017 01:19:11 +0000
Weathering a storm like Hurricanes Harvey, Irma or Maria requires planning,...
Tue, 17 Oct 2017 00:53:46 +0000
Minnesota chiropractor and two co-defendants have been convicted by a feder...
Tue, 17 Oct 2017 00:43:20 +0000
Wayne Wignes, a specialist in aviation and aerospace insurance, has joined ...