home
about us
request workman's comp
request certificates products
contact us
Glossary

 

 

 

 

Request Certificates

Contractors Insurance Specialists is a family owned business, SPECIALIZING in Contractor's insurance needs, with low broker fees, personal service and exceptional quality. We have the expertise in servicing the insurance needs of contractors of all types and sizes, this has been developed over the past 40+ years.

This experience enables us to obtain the best coverage at the lowest price for our clients.
We can do the same for your business. We look forward to servicing you!

Your protection and security are our primary concern.

CONTRACTORS INSURANCE SPECIALISTS
PO Box 2880
Lake Havasu City, AZ 86405
(928) 846-3224
lana@thecontractorsinsurancespecialists.com

Fill out our online form below to request a general liability quote (contractor insurance)

Click here for a printable version to mail or fax us (Otherwise, proceed below to submit an online form to our e-mail).


Items marked with * important to fill out but not required. Please fill in as much of the online form as you can.

*Contractor License Number:
 
*Business Name:
 
*Business Address:
 
*City:
 
*State:
 
*Zip:
 
*Owner/Contact Name:
 
*Number of Active Owners:
 
*Business Phone:
 
  Mobile Phone:
   
  Business Fax:
 
*Business Email:
 
*Estimated Gross Annual Receipts:
$
 
*Estimated Annual Field Payroll:
$
 
*Estimated Annual Sub-Out Cost:
$
 
 
Do you provide any new ground up construction?

Yes     No

 
*Claims in the Last Three Years?:
Yes     No
 
*Years Continuous Liability Coverage:
0     1     2     3
 
  Current Insurance Carrier:
 
  Policy Expiration Date:
 
*Number of Years in Business:
 
*Type of Work You Do:
Explain your Operations
 
*Request Additional Information
Check-mark which areas you would like more information on.
Bonds
Equipment
Commercial Truck Coverage
Workman's Comp (Simply check-mark for additional information).
Life Insurance
Health Insurance
   




© Copyright 2010 Contractors Insurance Specialists. Lana Kackstetter, Commercial Account and Employee Benefits Specialist
Arizona Lic #945273* | 925331* | Nevada Lic #636506* | Privacy Policy | Website by Eloquence