Thank you for your interest in receiving a business insurance quote with Outdoor AdvINSURE. This form should only take about 5-10 minutes to complete. Don't worry if you don't have everything. You can always click the "Save and continue later" button below. We'll email you a private link to pick up where you left off.

When do you want the policy, or policies, to start?*

Which type of insurance are you looking for?*

Check all that apply.

General Liability

Workers Comp

Commercial Auto

Garage Dealers Policy

Professional Liability (E&O)

Property

Equipment Floater (Tools coverage, etc.)

Cyber Liability

Other

Other type of insurance*

Insured Name*

Date of Birth*

Email*

Mobile Phone*

May we text you regarding your insurance?*

Yes

No

Work Phone

Business Information

Legal Business Name*

DBA

Entity Type*

FEIN

Number of Owners*

Business Website

Business Address*

Street Address City State Zipcode

Is this business affiliated with a franchise?

No

Yes

Insured Drivers License Number*

Insured Drivers License State*

Additional Business Owners

Owner 2: Name*

First Last

Owner 2: Date of Birth*

Owner 2: Email

Owner 2: Phone

Third Owner?

Yes

Owner 3: Name*

First Last

Owner 3: Date of Birth*

Owner 3: Email

Owner 3: Phone

Fourth Owner?

Yes

Owner 4: Name*

First Last

Owner 4: Date of Birth*

Owner 4: Email

Owner 4: Phone

Vehicles

Number of Vehicles*

Are all vehicles titled in the name of the business?*

Yes

No

1. VIN*

1. Year*

1. Make*

1. Model*

2. VIN*

2. Year*

2. Make*

2. Model*

3. VIN*

3. Year*

3. Make*

3. Model*

4. VIN*

4. Year*

4. Make*

4. Model*

5. VIN*

5. Year*

5. Make*

5. Model*

6. VIN*

6. Year*

6. Make*

6. Model*

7. VIN*

7. Year*

7. Make*

7. Model*

8. VIN*

8. Year*

8. Make*

8. Model*

9. VIN*

9. Year*

9. Make*

9. Model*

10. VIN*

10. Year*

10. Make*

10. Model*

Drivers

Number of Drivers*

Please include yourself if you are a driver.

Do any of your drivers take the vehicle(s) home at night?*

No

Yes

Do all drivers have a clean driving record?*

Yes

No

1. Driver Name*

1. Date of Birth*

1. Driver License Number*

1. Driver License State*

2. Driver Name*

2. Date of Birth*

2. Driver License Number*

2. Driver License State*

3. Driver Name*

3. Date of Birth*

3. Driver License Number*

3. Driver License State*

4. Driver Name*

4. Date of Birth*

4. Driver License Number*

4. Driver License State*

5. Driver Name*

5. Date of Birth*

5. Driver License Number*

5. Driver License State*

6. Driver Name*

6. Date of Birth*

6. Driver License Number*

6. Driver License State*

7. Driver Name*

7. Date of Birth*

7. Driver License Number*

7. Driver License State*

8. Driver Name*

8. Date of Birth*

8. Driver License Number*

8. Driver License State*

9. Driver Name*

9. Date of Birth*

9. Driver License Number*

9. Driver License State*

10. Driver Name*

10. Date of Birth*

10. Driver License Number*

10. Driver License State*

Commercial Auto Information

Radius of Operations*

Federal Safety Rating

Trucking Liability*

Cargo Liability

Cargo Deductible

Trailer Interchange

Yes

No

Reefer Breakdown

Yes

No

General Liability

Yes

No

Motor Truck Cargo

Commodities Hauled

Please list the types of commodities your business hauls.

Are they Hazardous?

No

Yes

Average Value

Maximum Value

Business Information Continued

What is your total annual sales? (Gross)*

What is your total annual gross commission?

Only for commission based businesses such as real estate, mortgage brokers, insurance agents, car dealerships, etc.

Do you have employee(s)?*

Yes

No

Do you lease your employees?*

No

Yes

Number of employees*

Estimated annual payroll*

Do you use any subcontractors? (1099s)*

Yes

No

How many subcontractors?*

Subcontractor annual payroll*

What type of work do your subs perform?*

Do you have a written contract with your subs requiring them to name your business as Additional Insured and show proof every year?*

Yes

No

Not yet

What year did the business start?*

Years of experience operating this business?*

Years of experience in this field?*

Additional Business Locations

Location 2: Address

Street Address Address Line 2 City State ZIP Code

Third Location?

Yes

Location 3: Address

Street Address Address Line 2 City State ZIP Code

Fourth Location?

Yes

Location 4: Address

Street Address Address Line 2 City State ZIP Code

Building Information

Year Built*

Number of stories of the building*

Construction Type*

Roof Type*

Other construction type*

Other roof type*

Has there been any updates to the roof, plumbing, or electrical?*

No

Yes

I don't know

Year Roof Updated?

Year Plumbing Updated?

Year Electrical Updated?

Business Description

Please describe the nature of your business*

Manufacturing

Is there any manufacturing, mixing, re-labeling, or repackaging of products?*

No

Yes

Please describe

Claims Information

Have you had any claims or losses in the last 5 years?*

No

Yes

What was the date, amount paid, and description of each loss or claim*

Current Insurance

Do you have ANY business insurance currently?*

No

Yes

Name of current insurance carrier?*

Expiration date of current policy*

Current total insurance premium?

Why are you looking for a new quote?

Current Policies

You may upload copies of your current policies here.

File types allowed: .pdf

Each file maximum size: 5MB

Maximum files: 10

Drop files here or

Accepted file types: pdf, Max. file size: 5 MB, Max. files: 10.

Liability Limits (Optional)

What is the Liability limit requested?

Do you need any Business Personal Property coverage?*

Yes

No

Not sure, let's discuss

How much Business Personal Property coverage do you want?

Are you interested in Loss of Use / Business Income coverage?*

Yes

No

Not sure, let's discuss

Garage & Dealers Information

List the percentage of the work you provide for each section below.

Where work is performed. Total must equal 100%.

Percent of work performed at Your Shop

% at Your Shop

Percent of work performed at Customer's Location

% at Customer's Location

Percent of work performed at Other

% Other

0%

Please describe Other Location

Type(s) of work performed (in percent). Total must equal 100%.

Type of Work: Body/Paint

% Body/Paint

Type of Work: Brakes, Transmission or Suspension

% Brakes, Transmission or Suspension

Type of Work: Electrical

% Electrical

Type of Work: Mechanical

% Mechanical

Type of Work: Muffler/Radiator

% Muffler/Radiator

Type of Work: Oil Change

% Oil Change

Type of Work: Roadside Assistance

% Roadside Assistance

Type of Work: Safety Inspection

% Safety Inspection

Type of Work: Tires/Wheels

% Tires/Wheels

Type of Work: Tune Up

% Tune Up

Type of Work: Wash/Detail

% Wash/Detail

Type of Work: Welding

% Welding

Type of Work: Other

% Other (Upholstery, frame work, body work, window tint, windows, cleaning trailer, stereo system, etc.)

0%

Please describe Welding type of work performed*

Please describe Other type of work performed*

Do you provide any off-site services or mobile services?*

No

Yes

What is the maximum miles away from your business that you offer your services?*

Dealer Sales Questions

How many Dealer Plates do you have?*

Number of Repairer/Transporter plates owned by you?

Number of vehicles sold annually*

Number held for sale (Average #)*

Number held for sale (Maximum #)*

Number of vehicles sold on internet auction

Number of vehicles sold on consignment

Do you sell "salvage titled" vehicles?*

No

Yes

Yes: How much structural repair done?*

Additional Insured Information (Optional)

Do you have anyone that needs to be listed as Additional Insured?

No

Yes

Additional Insured Information. (i.e. Name & Address)

You may upload your additional insured documents using the upload field below.

Additional Insured Document(s)

You may upload up to 10 PDF documents. If you have more documents you can send them to your agent after they contact you.

Drop files here or

Accepted file types: pdf, Max. file size: 10 MB, Max. files: 10.

Additional Comments and/or Current Policy Upload (Optional)

Additional Comments

Any Additional Documents

You may upload up to 5 additional PDF documents here.

If a file is over 8MB please email to us at [email protected]

Drop files here or

Accepted file types: pdf, Max. file size: 8 MB, Max. files: 5.

Wrapping Up

What is the best time to call and discuss your quote?*

Please specify the best time to call*

Would you like a quote from a specific agent?

How were you referred to us?

Consent*

Like most insurance agencies, we use information from you and other sources, such as your driving and claims histories, insurance score, and other factors to calculate an accurate rate for your insurance. New or updated information may be used to calculate your renewal premium.

I Agree

All the above information is accurate and true to the best of my knowledge.*

Yes

Would you like to create a user account to manage your submissions?*

Yes, create my account

Not at this time

Username*

Password*

Enter Password Confirm Password

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Comments

This field is for validation purposes and should be left unchanged.

Business Information

Additional Business Owners

Vehicles

Drivers

Commercial Auto Information

Motor Truck Cargo

Business Information Continued

Building and Property Information

Additional Business Locations

Building Information

Business Description

Customer Data

Manufacturing

Claims Information

Current Insurance

Liability Limits (Optional)

Garage & Dealers Information

Garage & Dealers Information

Dealer Sales Questions

Additional Insured Information (Optional)

Additional Comments and/or Current Policy Upload (Optional)

Wrapping Up

Outdoor AdvINSURE Agency LLC

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Business Insurance Quote

Getting proper insurance for your business is easy

Business Information

Additional Business Owners

Vehicles

Drivers

Commercial Auto Information

Motor Truck Cargo

Business Information Continued

Building and Property Information

Additional Business Locations

Building Information

Business Description

Customer Data

Manufacturing

Claims Information

Current Insurance

Liability Limits (Optional)

Garage & Dealers Information

Garage & Dealers Information

Dealer Sales Questions

Additional Insured Information (Optional)

Additional Comments and/or Current Policy Upload (Optional)

Wrapping Up

Outdoor AdvINSURE Agency LLC

Follow Us

Get A Quote

For Clients

Navigation

Sign In

Don’t have an account?