Business Insurance Quote

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Complete the details below to get your free business insurance quote

* Indicates required field

Business Name *

Please enter the official name of your business.

Business Address, City, State & Zip *

Enter your Business Address, City and Zip Code

Year Registered? *

Enter in the actual date the business was registered with the state of MN

Years in Business? *

Enter in how many years you have been in this business. Include prior experience

Legal Entity *

Please enter the legal status of your business.

E I N *

Employers Identification Number

Partners/Owners *

Please enter the number of owners or partners in the business.

Full-Time Employees *

Please enter the number of regular full-time employees your business has.

Business Personal Property *

Annual Payroll *

Enter in your annual payroll not including owners salary. (unless the owner(s) are to be included in the WorkComp)

Year Built *

What is the year the building was constructed where the business operates? Approx.

Part-time Employees *

Please enter the number of regular employees your business has who work part-time.

Sub-Contractors *

Please enter the number of regular sub-contractors your business employees in any given year.

Is this a one-time event or seasonal business? *

Annual Revenue *

Please enter the estimated annual sales of your business.

Will this replace an existing business policy? *

Square Footage of Business Space *

Total Square Footage of Space

Please describe the specific nature of your business. *

Please describe what your business does and all the typical services and products you provide on a regular basis.

When would you like this policy to start? *

Please enter when you’d like this new insurance policy to go into effect.

What type(s) of business insurance are you interested in?

Property/Casualty Insurance *

General Liability Commercial Property Commercial Auto Professional Liability Directors and Officers Liability Business Owners Package (BOP) Workers Compensation Cyber-Liability Liquor License Liability

Please select all that apply

Employee Benefits *

Group Health Insurance Group Life Insurance Group Disability Insurance 401K / Retirement Plans Supplemental Plans / AFLAC Key Man Life Insurance Key Man Disability Insurance Deferred Compensation

Business Owners Name *

First

Last

Please enter your first and last name

Date of Birth *

This is to verify ownership only.

Contact Email *

Please enter the best email address we can use to send your insurance quote.

Phone Number *

Please enter any additional information we may need to provide you an accurate insurance quote. You can also use this space to ask questions.

How did you hear about us? *

Additional Comments? *

Please enter any additional information we may need to provide you an accurate insurance quote. You can also use this space to ask questions.

🔒 Your information is secure.

Your private information is provided exclusively to our agency and will not be redistributed or sold to anyone else.

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IntegraSurance Group
(612) 275-5213
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