Certificates of Insurance for New Customers

START YOUR QUOTE for Business Insurance

About You or Your Business

Name*

first last

Business Name or DBA

If you do not have a business name, just write "none"

Address*

Street Address Address Line 2 City State ZIP Code

Email*

Enter Email Confirm Email

We use your email address to send you a quote, questions, or to help you with insurance. We DO NOT add you to a mailing list.

Phone Number - including area code*

We use this to call you about your quote request to help you.

Website Address

If you have a website, please type it in this box.

Business Structure*

Business Location

We ask this questions because different insurance carriers have different rules regarding the location of your business. It helps us find the right type of policy.

Do you have current insurance that is in force (or active) for your business?*

Information to Get Your Quote

Type of Business #1*

Choose the types that represent your business (you may choose more than one) by selecting another on the next drop down. Please choose AT LEAST ONE business type. ** If you cannot find your business, choose OTHER

What are your estimated gross receipts from this part of your business?*

This means the estimated amount of money that you make before your expenses. You can estimate. If you are a new business, please write your estimate, because to obtain most quotes, an amount must inputted.

Other Business Type - please describe your operations*

Please provide a full description

Type of Business #2

Other Business Type - please describe your operations

What are your estimated gross receipts from this part of your business?

Type of Business #3

Other Business Type - please describe your operations

What are your estimated gross receipts from this part of your business?

Describe your Business or Organization*

Please provide a description of what your business does. If you sell a product, list the types of products that you sell.

What types of insurance are you seeking?

We make it easy by asking you the only the questions

In what year did you start your business?*

What year did your business start?

How many employees do you have?*

You can write "0" if you have do not have any.

What percentage of your work is done by independent contractors or 1099s (estimate) is acceptable?*

How much do you pay your independent contractors (1099s) annually? Estimate OK

If you have no subcontractors, please write 0 (zero).

Does a single client represent 50% or more of your business?

Tell us about the customer that provides more than 50% of your business.

What services do you perform for this customer and what are your estimated annual receipts (earnings before expenses) from this customer.

Do you have any prior claims?

Tell us About your Prior Claim

TAX ID / FEIN / Social

To quote workers compensation insurance, we need your Tax ID, FEIN, or Social if you are a sole proprietorship. For general liability, we will need it when you bind the policy.

Chose your Limits of Liability

General Liability

These numbers are written as the per occurrence limit and the aggregate limit. More information

Professional Liability - Errors and Omissions Insurance

Property Insurance Section

In this section, you can choose how much coverage you want for your equipment, a building, glass, or other items.

Do you own the building?

How much coverage ($) do you want for the building?

Enter an amount in this box. The underwriter will still require that your amount of coverage meet a minimum rebuilding cost per square foot. We will contact you with more information.

How much coverage ($) for your business personal property at your location?*

This includes your furniture, inventory, printers, file cabinets, etc. We'll ask you about computers in the next box.

How much coverage ($) for your business personal property AWAY from the premises?*

Remember that business personal property (BPP) is generally only covered at the address listed on your policy. This is the space where you tell us how much coverage you want quoted for equipment or tools away from the premises you listed above.

How much coverage ($) do you want to Tenant Improvements?

This includes, flooring, painting, wallpapering, and other permanent renovations that you did to you space. Also include permanently mounted equipment here.

How much coverage ($) for computers and laptops?

How much coverage ($) for awnings or canopies?

How much coverage ($) for Signs?

Signs are expensive to replace, so let us know the value or your signed mounted to the building or that's not connected.

What Year was the building that you are in built? (Estimate OK)

Have the roof, heating, electrical and plumbing have all been updated in the last 15 years?*

Do you want coverage for any specific items? Tell us about them and include the value.

If you know the year, make, and model of your equipment, please provide it. We will contact you for more information, if needed. Example: 1 tractor, 2005 model, $25000 value.

Does your location have any of the following?

Central Station Alarm - one that calls the alarm company or the police
Local Alarm Only - it does not call the policy or an alarm company
Fire Sprinklers on the interior - covering 100% of the building
Fire Sprinklers on the interior - covering only part of the building
A security guard
Video Cameras

Commercial Auto Section

Driver #1 - Provide the name at least 1 driver*

Driver #1 - Birthdate*

Driver #1 - License Number*

Driving Record for Driver #1

Do you have a COMMERCIAL DRIVER LICENSE (CDL)?*

Vehicle #1 - Year, make, and model (if you have the VIN, include it)

Vehicle #1 - Year, make, and model (if you have the VIN, include it)*

Vehicle #1 - how much is it worth? (not including permanently attached equipment)*

Vehicle #1 - how much coverage do you want for permanently attached equipment*

Examples: a dog grooming truck may have a vacuum permanently mounted; a food truck may have cooking equipment mounted to the truck.

Do you need to add more drivers or vehicles?

Yes
No

Tell us about the other drivers and/or vehicles. Please provide the name, birthdate, and marital status of each driver. Provide the year/make/model and value of each vehicle. If you know the VINs, please provide them.

If there is something special that you want to tell us, please do so here.

Translator or Interpreter Section

Do you do simultaneous translation where 2 or more interpreters translate/interpret at once?

Do you do any translating for medical professionals?

What types of clients do you service?

Carriers have different rules about the types of clients you service, so this help us with the quoting process.

Do you do work for a translating agency that sends you clients to translate/interpret?

Which agencies give you assignments?

We can create a certificate of insurance, if you need.

Thrift Store or Consigment Store Section

Do you sell motorcycles, automobiles, children’s car seats, bunk beds, children’s, cribs, firearms or ammunition.

n most cases, if you sell any of these items, there will be a products exclusion added to your policy. More information will be available once your quote is completed.

Do any of the following apply to your business? (Check as many as you need)

We refinish furniture
We make or repackage a product and put or name or label on it
We are a pawn shop
We sell cars, motorcycles, weapons, or ammunition
We sell guns

Athletics Section

Please Check All that Apply

We train professional athletes
Olympic training is part of my business
We use independent contractor trainers
We use employee trainers
Our location also provides day care services
Our location also provides massage services
We have a registered dietitian or nutritionist as part of the business

How many students do you have ages 0-12?

How many students do you have ages 13-15?

How many students do you have ages 16-17?

How many students do you have ages 18+ (adults)?

Choose all sports that apply

Mobile Home Park Questions

How many spaces do you have at your park?

Do you own any of the homes and rent them to tenants?

Do you have a fence, gate, or wall around your park?

Do you allow motor homes or short-term rentals?

E-Cig and Vaping Section

How do you get your products?

Tell us if any of these appy to you.

I also see tobacco products
I sell Hookah Products

Tell us more about your business - check all that apply

I run a retail store
I sell products online
I am a distributor or wholesaler (I sell to retail stores)
I manufacture products

Are you looking for products liability?

Field Inspector Section

Do you do property preservation work too?

Description of Field Inspection Work

Please tell us what you do, such as occupancy checks, photographing homes, or something else.

Drone Business Section

Describe Your Business

What is the usage of the drones that you design? (personal, commercial, government) Provide Details*

Janitorial and Property Preservation Section

Do you do any of the following: Aircraft service or maintenance, Building construction or renovation and other contracting operations including construction site clean up, Building security or guard services, Chimney cleaning, Elevator maintenance Exterior window cleaning higher than one story not involving ground level cleaning with an extension pole Greater than 25% fire, water, smoke flood or other disaster restoration service operations,

Are you or your firm currently involved in, or in the next 12 months, plan to be involved in any of the following: Auto repossession, Construction services, Eviction services, Handling/removing hazardous waste, Key for money services, Mold Remediation, Mortgage brokering, Real Estate appraisal, Storm proofing services

Do you do any roof repair?

Do you do any mold remediation work?

Do you do work at or on homes valued at over $1,000,000?

Are you also a mortgage field inspector?

Petting Zoo, Animal Show Groomer, Kennel, Trainer, or Pet Sitter Questions

Choose all that apply to your business

I/we groom dogs, cats, or birds
I/we groom non-domestic animals (like horses or sheep)
I/we kennel animals - meaning that they stay overnight at my place
I/wepet sit - meaning that I go to customers homes to walk or care for their animals
I/we house sit - meaning that I/we stay at peoples' homes overnight

Do you train any animals?

No
Yes

What types of animals do you train?

Breeding - Do you BREED any animals?*

No
Yes

What animals do you breed? To whom do you sell them?

Beauty Insurance Questions

Do you provide any services other than cutting hair, styling/dyeing/drying hair, facial/eyebrow waxing (not body), manicures, or pedicures?*

Please Check the Boxes for All the Services You Offer

What other services do you provide? Please list all services.

How many FULL time beauty professionals do you have?

How many PART TIME beauty professionals do you have?

Manufacturer Section

Where are your products manufactured?

Have you ever had a product recalled?

What do you manufacture?

Give us some specifics or examples of what you make.

Animal Industry Questions

Do you offer pony rides?

Are there any venomous creatures involved in your show?

Can people touch the animals or other creatures at your show?

Do you have hand washing stations?*

Do you have any big cats as part of your show?

List all of the animals / reptiles that are present at your zoo or show or that you use as part of your business*

Tell us if you offer any additional activities as part of your business?

Manufactured Home Dealer Section

Do you sell new and used manufactured homes?

Do you want coverage for physical damage to the manufactured homes on your lot?

Mobile Home Park, RV Park, or Camp Ground Section

Do you have longer-term renters at your lot?

Do you own any units at the park that you rent out?

Do you have hookups for gas, water, or electric?

Do you have a playground, swimming pool, or club house?

Playground
Swimming Pool
Club House

What security measures do you have?

Guard at entrance
On premises security
3rd party security company drives around
Gate or fence around the property
People entering must pass through a gate to come on the property
Outdoor lighting throughout the property

Trucking Section

What types of products do you haul?*

What is your travel radius in miles (how many miles do you travel from your main location)?*

Do you travel outside of the state?*

Do you haul anything to a dump site (like a garbage dump)?*

Do you have general liability insurance? ** DISCOUNT may be available*

Professional Liability (Errors and Omissions / E&O) Questions

Does the person to be insured have knowledge or information of any act, error or omission which might reasonably be expected to give rise to a claim against him/her?

We are asking if you know of anything that may result in a claim. For example, has someone threatened to sue you?

Within the past 5 years, have any claims been made or legal action brought against the firm, its predecessor(s), or any past or present principals, partners, insurance managers, or employees?

We are asking if you have ever had a claim.

Online Business Questions

Please provide a detailed description of the products that you sell or the services that you offer online*

Do you have a physical location?*

Virtual Reality Section

Please provide a complete description of your business and how you use virtual reality in your business*

Inland Marine | Contractors Equipment | Insurance for Specific Items

What do you want to insurance? Please provide a description, the value of each item, and the year of manufacture (if known)*

Example: 2015 John Deere F450 Tractor $25000

School Insurance Section

How many students are enrolled in your school each month?

How many teachers or instructors do you have?*

Do you run a background check on all of your instructors?

Special Event

How many guests will visit your special event - estimate is acceptable?*

Will any famous performers be present? Please provide a list.

Pedal Crawler and Bike Tour Section

Are you seeking any of these coverages?

Liquor Liability
Commercial Auto
Inland Marine - for unlicensed (no license plate) pedal crawlers and bike tours

• How many units will be run over the next 12 months

Pressure Washing or Hood, Duct, or Kitchen Exhaust Cleaning

How many active owners do you have that actually perform your service? This does not included clerical or secretarial owners.*

What is your annual payroll to your employees (not the owners)?*

What is your payroll to sub-contractors or sub costs?*

Many insurance carriers use your subcontractor costs to determine a price. Please use your best estimate. If you use no sub contractors, write "0" (zero).

Do you do any work in Colorado or in the following counties of New York: Bronx, Kings, Nassau, New York, Queens, Richmond, Suffolk and Westchester.*

Do you only clean restaurant hoods and ducts?*

Do you do any work in work in airports, government or military institutions, hospitals, nursing homes, detention or correctional facilities.*

Do you have any certifications or have you completed any programs for hood or duct cleaning?

Contractor and Installation Business Questions

What is your payroll to sub-contractors or sub costs?*

Many insurance carriers use your subcontractor costs to determine a price. Please use your best estimate. If you use no sub contractors, write "0" (zero).

What is your annual payroll to your employees (not the owners)?*

The last questions - finish your quote

By clicking the "Submit” button, I consent to receive autodialed and/or pre-recorded telemarketing calls and/or text messages from Stratum Insurance Agency and its representatives in order to provide me with insurance quotes and other products or services at the telephone number I provided. I also consent to the Stratum Insurance Agency LLC Privacy Policy and Terms of Use. I understand that I may receive a call even if my telephone number is listed on a Do Not Call list and that my consent is not a requirement of purchase.

Yes

We may send you a text message to let you know that your quote is ready.

Do you use drones in your business?*

Only some carriers allow this, so we will work to find one that does.

Do you want to subscribe to our small business newsletter?

Yes, please
No, thank you

We do not send a lot of newsletters, but when we do, they are filled with valuable risk prevention and small business ideas.

Certificate of Insurance for People or Businesses that are not Current Customers

How to Get a Certificate of Insurance

START YOUR QUOTE for Business Insurance

About You or Your Business

Information to Get Your Quote

Chose your Limits of Liability

Property Insurance Section

Commercial Auto Section

Translator or Interpreter Section

Thrift Store or Consigment Store Section

Athletics Section

Mobile Home Park Questions

E-Cig and Vaping Section

Field Inspector Section

Drone Business Section

Janitorial and Property Preservation Section

Petting Zoo, Animal Show Groomer, Kennel, Trainer, or Pet Sitter Questions

Beauty Insurance Questions

Manufacturer Section

Animal Industry Questions

Manufactured Home Dealer Section

Mobile Home Park, RV Park, or Camp Ground Section

Trucking Section

Professional Liability (Errors and Omissions / E&O) Questions

Online Business Questions

Virtual Reality Section

Inland Marine | Contractors Equipment | Insurance for Specific Items

School Insurance Section

Special Event

Pedal Crawler and Bike Tour Section

Pressure Washing or Hood, Duct, or Kitchen Exhaust Cleaning

Contractor and Installation Business Questions

The last questions - finish your quote

Looking for a Quote