Commerce Group, Inc.
Business Quote
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If you wish to receive an accurate quote, please fill out the form completely. If you prefer you can give us your contact information only, and we will contact you by the next business day.
Name
required
First Name
Last Name
Business Name
required
Business Address
Address
Address Line 2
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Alabama
Alaska
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Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
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Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
American Samoa
Guam
Marshall Islands
Micronesia
Northern Marianas
Palau
Puerto Rico
Trust Territories
Virgin Islands
Armed Forces(AA)
Armed Forces(AE)
Armed Forces(AP)
Alberta
British Columbia
Manitoba
New Brunswick
Newfoundland
Northwest Territory
Nova Scotia
Nunavut
Ontario
Prince Edward Island
Quebec
Saskatchewan
Yukon Territory
City
State
Zip Code
Mailing Address (if different from location)
Address
Address Line 2
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Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
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
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
American Samoa
Guam
Marshall Islands
Micronesia
Northern Marianas
Palau
Puerto Rico
Trust Territories
Virgin Islands
Armed Forces(AA)
Armed Forces(AE)
Armed Forces(AP)
Alberta
British Columbia
Manitoba
New Brunswick
Newfoundland
Northwest Territory
Nova Scotia
Nunavut
Ontario
Prince Edward Island
Quebec
Saskatchewan
Yukon Territory
City
State
Zip Code
Home Phone
required
Phone Number
Work Phone
required
Phone Number
Email
required
Email Address
Business Website
required
Description of Business
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Type of Business Entity
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Select one
LLC
Corporation
Partnership
Sole Proprietor
Current Insurance Co.
required
Renewal Date of Current Insurance
required
Click in box to select date
How many years in business?
required
How many employees?
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Own or lease the building?
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Select one
own
lease
How many business autos?
required
Claims in the last 5 years?
required
What is the gross annual revenue?
required
Type of coverage needed
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Select all that apply
Liability
Property
Auto
Workers compensation
Inland marine
Tools and Equipment
Umbrella
Bond
* required