Firearm Quote Request

1
Is this for a new or existing business?* This field is required.
New
Existing
2
Is this for an operation that derives income from firearm retail sales to end users, a gun range or gunsmithing?* This field is required.
YESNO
3
Do you also derive income from gun or ammo manufacturing or wholesale distribution?* This field is required.
YESNO
4
Please check all sources of income for your business* This field is required.Check all that apply.
Ammunition manufacturing
Firearms retail sales
Firearms manufacturing
Firearms components manufacturing
Gunsmithing
Shooting range
Wholesale distributor
5
Business description* This field is required.Please provide detailed description of your business operations, how you began, what experience you have in this space, and where you see your business going in the next 3-5 years.
Huge
Large
Normal
Small
Ok
Ok
6
Name of the business entity?* This field is required.Include DBA(s) if applicable.
7
If you have a website, please enter it below:
8
Annual total gross revenue?* This field is required.If a start-up, please enter your anticipated amount
Less than $50,000
$50,000 - $100,000
$100,000 - $500,000
$500,000 - $1M
$1M - $2.5M
$2.5M - $5M
$5M - $10M
More than $10M
9
Primary Physical Address* This field is required.
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
Please Select
United States
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curacao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
10
Your first name?* This field is required.
11
Last name?* This field is required.
12
Email* This field is required.Your contact info is kept private and secure. It is used ONLY to discuss your quote with you.
example@example.com
13
And what phone number can we reach you at?* This field is required.Your contact info is kept private and secure. It is used ONLY to discuss your quote with you.
Please enter a valid phone number.
14
What has you exploring insurance options?Check all that apply.
Premiums are too high
I'm not confident in my current coverage
Just starting out - new business
The business is changing and we need some guidance
I'm trying to keep my current agent honest
I'm frustrated with my current agent
I'm frustrated with my current insurance carrier
Just curious about options
15
How soon are you looking to have an insurance solution in place?
Need it ASAP
Within 1-2 weeks
Within the next 30 days
No rush
16
Agent Email
example@example.com
17
Unfortunately, at this time we are unable to offer insurance for retail storefront operations, gun ranges or gunsmithing operations. We hope you are able to find adequate insurance coverage elsewhere. Thank you for considering the Hummel Group.

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