Logging/Lumber Industry Quote Request

1
Name* This field is required.
First Name
Last Name
2
Submission Counter
3
Phone Number* This field is required.
Area Code
Phone Number
4
Email Address* This field is required.
5
What is the name of your business?* This field is required.
6
Physical/ Street 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
Curaçao
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
7
Is the mailing address the same as physical address?* This field is required.
YN
8
Mailing Address:* This field is required.
9
Mailing City:* This field is required.
10
Mailing State:* This field is required.
11
Mailing Zip Code:* This field is required.
12
What type of insurance are you looking for?* This field is required.
Property Insurance
Auto Insurance
General Liability Insurance
Umbrella & Excess Liability Insurance
Workers' Compensation
Employee Benefits & Health Insurance
401(k) & Other Financial Services
I'm not sure...
13
is this for a new or existing business?* This field is required.
New business
Existing business
14
What type of business is it?* This field is required.
Logging operation
Sawmill (stationary)
Sawmill (portable)
Log trucking
Other/combination of above
15
Please describe your business* This field is required.
16
Estimated gross annual revenue? (if new business, enter your projected revenue)* This field is required.
17
Number of employees?* This field is required.
18
Estimated annual payroll?* This field is required.
19
Please indicate your current insurance situation* This field is required.
Don't have insurance
Have insurance, but am looking to increase coverage and/or lower cost
20
Ok great. Would you like to upload your current insurance declarations page? It's optional, but streamlines the whole quoting process saving you time.* This field is required.
Sure, I'll upload it.
I'd rather enter info manually.
21
Please upload the declarations page of your current policy below.
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
Cancelof
22
Who are you currently insured with?
23
How many years have you been with your current insurance company?
24
Any claims filed within the last 3 years?* This field is required.
YESNO
25
No problem. Please give a brief summary of the claim(s).
Huge
Large
Normal
Small
Ok
Ok
26
Estimated total annual premium amount for your current insurance?* This field is required.
$0 - $10,000
$10,001 - $40,000
$40,001 - $90,000
$90,001+
27
Now we need to gather some information about your vehicles & equipment. Would you like to enter this manually or upload a schedule of these items?* This field is required.
Enter manually
I'll upload (or email) a schedule to you
28
Great! Please upload your vehicle & equipment schedule below:
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
Cancelof
29
Please list out your equipment/vehicles. Include:Year - Make - Model - Value - Serial Number (if possible)Tip: If on a computer, start a new line by pressing "enter" while holding the "shift" key
30
Ok. Now for buildings. Are there any buildings or property that needs to be insured?* This field is required.
YN
31
Would you like enter info on the property manually or upload a schedule of the property?
Enter manually
I'll upload
32
Great! Please upload the property schedule below:
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
Cancelof
33
Ok, please enter: 1) The building's value, 2) Value of the contents of the building, 3) Whether the building is pole framed (wood) or steel framed* This field is required.
Huge
Large
Normal
Small
Ok
Ok
34
Anything else you want us to know about the equipment or property of your business?(optional)
35
Now, for driver information. Do you have any drivers of vehicles owned by your business?* This field is required.
YN
36
Would you like to enter driver information manually or upload a schedule of these items?* This field is required.
Enter manually
I'll upload (or email) a schedule to you
37
Great! Please upload the driver schedule below:
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
Cancelof
38
Alright. Please list out drivers and include the following (to the best of your ability) Name - Date of birth - License number* This field is required.
39
Any other documents you need to upload? Please upload here.
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
Cancelof
40
What made you start shopping for insurance today?* This field is required.e.g. cost savings, better protect your assets, reduce liabilities, insurance required for a job or vehicle purchase, etc.
41
Last question, and its an easy one. How did you find us?* This field is required.
Referral/word of mouth
Online search
Radio ad
Print ad
Should be Empty: