Get a Business Insurance Quote

Artisan Contractor Quote Request

This is used to collect initial business information to assess eligibility and needs.

Business Information

Business Name *

FEIN

DBA / Tradename

Contact Name and Title *

Business Entity Type

Description of Operations *

Years in Business

Years of Management Experience in This Industry

Contractor's License # (if required in any state you operate in)

Business Address *

Building Information

Year Built

Fire Sprinkler System

Yes No

Construction Type

Building Coverage Amount (if Building Owner)

Tenants Improvements & Betterments Coverage (if Tenant)

Business Property (Contents) Coverage Amount

Location Deductible

Financials

Liability Limit

Total Gross Annual Receipts

% of Gross Annual Receipts from Work Subcontracted by You

Number of Active Owners (excl. clerical)

Number of Full-Time Employees

Number of Part-Time Employees

Annual Payroll

Tools & Equipment Replacement Cost — Blanket Coverage (items under $2,000)

Tools & Equipment Replacement Cost — Scheduled Coverage (items over $2,000)

Approximate Renewal Date

Current Carrier Name and Policy #

Loss History

Auto Details

Fill this in only if you need vehicles covered.

# of Drivers

# of Vehicles

Driver 1

First Name

Last Name

Date of Birth

Driver's License Number

State of License

International License?

Yes No

Driver 2

First Name

Last Name

Date of Birth

Driver's License Number

State of License

International License?

Yes No

Driver 3

First Name

Last Name

Date of Birth

Driver's License Number

State of License

International License?

Yes No

Vehicle 1

VIN

Special Mounted Equipment?

Vehicle 2

VIN

Special Mounted Equipment?

Vehicle 3

VIN

Special Mounted Equipment?

Vehicle 4 (optional)

VIN

Special Mounted Equipment?

Anything Else We Should Know? (additional vehicles, notes, etc.)

Your Phone *

Your Email *

Acceptance

By clicking Submit, you consent to receiving calls, texts, and emails from REARDON AGENCY.

Quote Authorization

By submitting this request, you authorize Reardon Agency LLC and Ryan Reardon to use the information provided to prepare and obtain an insurance quote on behalf of the business named above — including contacting insurance carriers, requesting loss history or claims information, and verifying the details submitted. You confirm you are authorized to provide this information on behalf of the business.

I agree to receive calls, texts, and emails from Reardon Agency LLC about this quote request. Message & data rates may apply. Reply STOP to opt out. *

I authorize Reardon Agency LLC to obtain a quote on behalf of this business using the information provided, and confirm I am authorized to do so. *

✅

Request Received!

Ryan will review your information and follow up shortly with next steps.

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Retail, Office & Service Quote Request

This is used to collect initial business information to assess eligibility and needs.

Business Information

Business Name *

FEIN

DBA / Insured Name

Contact Name and Title *

Business Entity Type

Description of Operations *

Years in Business

Years of Management Experience in This Industry

Business Address *

Building Information

Hours of Operation — Open

Hours of Operation — Close

Year Built

Fire Sprinkler System

Yes No

Construction Type

Building Coverage Amount (if Building Owner)

Tenants Improvements & Betterments Coverage (if Tenant)

Business Property (Contents) Coverage Amount

Location Deductible

Liability Limit

Financials

Number of Full-Time Employees

Number of Part-Time Employees

Total Annual Receipts

Approximate Renewal Date

Current Carrier Name and Policy #

Loss History

Your Phone *

Your Email *

Acceptance

By clicking Submit, you consent to receiving calls, texts, and emails from REARDON AGENCY.

Quote Authorization

By submitting this request, you authorize Reardon Agency LLC and Ryan Reardon to use the information provided to prepare and obtain an insurance quote on behalf of the business named above — including contacting insurance carriers, requesting loss history or claims information, and verifying the details submitted. You confirm you are authorized to provide this information on behalf of the business.

I agree to receive calls, texts, and emails from Reardon Agency LLC about this quote request. Message & data rates may apply. Reply STOP to opt out. *

I authorize Reardon Agency LLC to obtain a quote on behalf of this business using the information provided, and confirm I am authorized to do so. *

✅

Request Received!

Ryan will review your information and follow up shortly with next steps.

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Workers' Compensation Quote Request

The more detail you can provide, the faster and more accurate your quote will be.

Business Information

Business Name *

Insured Name

Business Address *

Business Phone *

Email *

Website / Social Media (if applicable)

FEIN

Business Entity Type (Sole Proprietorship, Corporation, etc.)

Approximate Renewal Date

Business History

Is this a newly formed business, or are you hiring employees for the first time?

Yes No

Year Business Was Established

Year Current Ownership Was Established

Year Employees Were First Hired Under Current Ownership

If coming out of an Assigned Risk Plan, what month/year?

Is your Property & Casualty coverage also with Farmers?

Yes No

Class Codes & Payroll

If you have more than one location, list each location's class codes separately in the notes at the bottom. Your current Workers' Comp declarations page (if you have one) usually lists the right class codes.

Class Code 1

Class Code

Description

Annual Payroll

# Full-Time / # Part-Time

Class Code 2 (optional)

Class Code

Description

Annual Payroll

# Full-Time / # Part-Time

Class Code 3 (optional)

Class Code

Description

Annual Payroll

# Full-Time / # Part-Time

Owners / Executive Officers

"Own %" = ownership stock percentage. "Incl/Excl" = whether this officer is included in or excluded from the policy.

Owner / Officer 1

Name

Title (President, VP, Sole Proprietor, etc.)

Ownership %

Included or Excluded

Included Excluded

Payroll (if included)

Exposed to Operational Hazard?

Yes No

Owner / Officer 2 (optional)

Name

Title

Ownership %

Included or Excluded

Included Excluded

Payroll (if included)

Exposed to Operational Hazard?

Yes No

Industry-Specific Questions

Describe the Business Operations (and Products)

Do you hire contract employees or pay employees with a 1099?

Yes No

If yes, did this start prior to this year?

Yes No

Do you subcontract any work?

Yes No

If yes, are all subcontractors required to provide a certificate of insurance?

Yes No

Prior Carrier & Loss History

Prior Insurance Carrier

Self-Insured / Professional Employer Organization (PEO) / Captive?

Yes No

Experience Modification Factor (if known)

Is your WC coverage currently canceled or pending cancellation?

Yes No

Has your WC coverage been canceled (for reasons other than non-payment), non-renewed, or lapsed in the last 3 years?

Yes No

Any loss occurrences in the past 3 years?

Yes No

Do you have Loss Runs no more than 120 days old?

Yes No

Loss History — Year 1 (most recent)

Policy Premium

Total # of Losses

Total Loss Value

# of Losses Over $25K

Loss History — Year 2

Policy Premium

Total # of Losses

Total Loss Value

# of Losses Over $25K

Loss History — Year 3

Policy Premium

Total # of Losses

Total Loss Value

# of Losses Over $25K

Employer's Liability Coverage

Typical default limits are $100,000 / $100,000 / $500,000 (Bodily Injury by Accident / by Disease per employee / by Disease policy limit) — enter your desired limit if you know it, or leave blank to use the default.

Employer's Liability Limit (if known)

Additional Notes (extra locations, class codes, owners, etc.)

Acceptance

By clicking Submit, you consent to receiving calls, texts, and emails from REARDON AGENCY.

Quote Authorization

By submitting this request, you authorize Reardon Agency LLC and Ryan Reardon to use the information provided to prepare and obtain an insurance quote on behalf of the business named above — including contacting insurance carriers, requesting loss history or claims information, and verifying the details submitted. You confirm you are authorized to provide this information on behalf of the business.

I agree to receive calls, texts, and emails from Reardon Agency LLC about this quote request. Message & data rates may apply. Reply STOP to opt out. *

I authorize Reardon Agency LLC to obtain a quote on behalf of this business using the information provided, and confirm I am authorized to do so. *

✅

Request Received!

Ryan will review your information and follow up shortly with next steps.

Back to Business Insurance

Business Insurance Quote Request

For any business type not listed above — restaurants, habitational/rental property, and everything else. Tell us about your business and what coverage you're looking for.

Business Information

Business Name *

FEIN

DBA / Trade Name

Contact Name and Title *

Type of Business / Industry *

Business Entity Type

Description of Operations *

Years in Business

Years of Management Experience in This Industry

Business Address *

Building Information

Year Built

Fire Sprinkler System

Yes No

Construction Type

Building Coverage Amount (if Building Owner)

Tenants Improvements & Betterments Coverage (if Tenant)

Business Property (Contents) Coverage Amount

Location Deductible

Liability Limit

What Coverage Are You Looking For?

Check all that apply — not sure? Check "Not sure" and Ryan will help you figure it out.

Financials

Number of Full-Time Employees

Number of Part-Time Employees

Annual Payroll

Total Annual Receipts / Revenue

Approximate Renewal Date

Current Carrier Name and Policy #

Loss History

Do You Use Vehicles in the Business? If So, How Many, and How Many Drivers?

Anything Else We Should Know?

Your Phone *

Your Email *

Acceptance

By clicking Submit, you consent to receiving calls, texts, and emails from REARDON AGENCY.

Quote Authorization

By submitting this request, you authorize Reardon Agency LLC and Ryan Reardon to use the information provided to prepare and obtain an insurance quote on behalf of the business named above — including contacting insurance carriers, requesting loss history or claims information, and verifying the details submitted. You confirm you are authorized to provide this information on behalf of the business.

I agree to receive calls, texts, and emails from Reardon Agency LLC about this quote request. Message & data rates may apply. Reply STOP to opt out. *

I authorize Reardon Agency LLC to obtain a quote on behalf of this business using the information provided, and confirm I am authorized to do so. *

✅

Request Received!

Ryan will review your information and follow up shortly with next steps.

Back to Business Insurance

Artisan Contractor

Retail, Office & Service

Workers' Compensation

Other Business Type

Artisan Contractor Quote Request

Request Received!

Retail, Office & Service Quote Request

Request Received!

Workers' Compensation Quote Request

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Business Insurance Quote Request

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