Begin HereStart Your Quote for Non-Profit InsuranceSTART YOUR QUOTEAbout the Non-profit or Social Service GroupName* First Last Name of Non Profit or Social Service or Group*If you do not have a business name, just write "none"Location Address (not mailing address)* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Do you have a different mailing address?CHOOSE ONENoYesWhat is your mailing address?*Email* Enter Email Confirm Email Phone Number - including area code*If you have a website, please write it belowEntity Structure*CHOOSE ONENon-Profit 501(c)(3)Non-Profit 501(c)(4)Non-Profit 501(c)(5)Non-Profit 501(c)(6)Individual - Sole ProprietorHusband and WifeGeneral PartnershipCorporationC-CorpS-CorpTrustLLC - Limited Liability CompanyLP - Limited PartnershipLLP - Limited Liability PartnershipLocation*CHOOSE ONEHome-based business working only from homeWe rent, lead, or own an office or other location away from my homeHome-based business but we travel to different locations to workWe work only at flea markets, festivals, and similar eentsWe own an office condoWe do not own or rent a space, but we work from spaces owned/rented by othersWe 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.Information to Get Your QuoteDescribe your Non Profit or Social Service*CHOOSE ONEAbused Adult Shelters (Battered Women)Affordable HousingAfter School TutoringAlcohol/Drug CounselingAlcoholics Anonymous MeetingsAnimal Shelters / Rescue GroupsAnxiety CounselingAssociations for Retarded Citizens (ARCs)At Risk Youth CounselingBattered Victims SheltersBehavioral TreatmentBig Brother / Big Sister OrganizationsBlind/Visually Impaired ServicesBotanical GardensBoys & Girls ClubsBoys & Girls ClubsBusiness & Citizenship ProgramsCampsCareer & Vocational CounselingCaregivers (Non Medical)Charitable Organizations Fundraising OrganizationsChild & Family ServicesChild Abuse Information & TreatmentChild CareCommunity & Business AdvocacyCommunity Action Centers (CACs)Community CentersCommunity CoalitionsCommunity ImprovementCongregate MealsConservation GroupsCounseling & ReferralCounseling &; Treatment Centers (Post Detox)Counseling for Eating DisordersCounseling ProgramsCredit Debt CounselingCrisis CentersCrisis Intervention (Non Suicide)Deaf/Hearing Impaired ServicesDisability ServicesDivorce CounselingDrug Abuse & Addiction InformationEmergency SheltersEmployee Training ServicesEthnic/Immigrant ServicesFamily CounselingFood BanksFood DistributionFood PantriesFunding OrganizationsGay / Lesbian ServicesGeneral Family ServicesGoodwill StoresGovernment Assistance ServicesGrant Making OrganizationsGrief CounselingGroup HomesGroup ResidentialHalfway HomesHalfway HousingHealthcare ClinicsHistorical SocietiesHomeless SheltersHorticultural SocietiesHospicesHousing for Retired ClergyHousing Support – Senior CitizensHuman Service OrganizationsJob Placement ServicesLearning Disorder ServicesLow Income HousingMarriage & Family CounselingMental Health ServicesMRDD Rehabilitation ServicesNeighborhood Multi Service CentersNutrition ProgramsOrphanagesOTHEROutreach ProgramsParenting EducationPastoral CounselingPregnancy Help CentersPrison Families Support ServicesPrivate FoundationsProfessional Societies, AssociationsPsychologist ServicesRape Counseling ServicesReading ProgramsReferral AgenciesRefugees & Settlement ServicesReligious OutreachRescue MissionsRescue MissionsSchool Social WorkSecond-Hand/Thrift StoresSelf-Help for AddictsSenior Activities Centers (Non Medical)Senior CentersSenior Independent LivingService LeaguesSettlement HousingSingle Parent Agencies / ServicesSleep Disorder CounselingSmoker’s Information & TreatmentSocial Service OrganizationsSoup KitchensSpeech TherapistsSpiritual CounselingStress Management ServicesSubsidized HousingSubstance Abuse Recovery (Post Detox)Support GroupsSupportive HousingTemporary HousingTemporary Relief ServicesThrift StoresTransitional HousingUnited Fund CouncilsUnited WayUnwed Mothers/Single ParentUrban LeaguesVictims of AbuseVocational Sheltered WorkshopsWomen’s Crisis ServicesWomen’s SheltersYMCAs/YWCAs, YMHAs/ YWHAsYouth CentersYouth ClubsYouth CounselingChoose 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. You can choose OTHER, if you cannot find yours here.Other Business Type - please describe your operationsAdditional Description (or skip if nothing applies to you)CHOOSE ONEAbused Adult Shelters (Battered Women)Affordable HousingAfter School TutoringAlcohol/Drug CounselingAlcoholics Anonymous MeetingsAnimal Shelters / Rescue GroupsAnxiety CounselingAssociations for Retarded Citizens (ARCs)At Risk Youth CounselingBattered Victims SheltersBehavioral TreatmentBig Brother / Big Sister OrganizationsBlind/Visually Impaired ServicesBotanical GardensBoys & Girls ClubsBoys & Girls ClubsBusiness & Citizenship ProgramsCampsCareer & Vocational CounselingCaregivers (Non Medical)Charitable Organizations Fundraising OrganizationsChild & Family ServicesChild Abuse Information & TreatmentChild CareCommunity & Business AdvocacyCommunity Action Centers (CACs)Community CentersCommunity CoalitionsCommunity ImprovementCongregate MealsConservation GroupsCounseling & ReferralCounseling &; Treatment Centers (Post Detox)Counseling for Eating DisordersCounseling ProgramsCredit Debt CounselingCrisis CentersCrisis Intervention (Non Suicide)Deaf/Hearing Impaired ServicesDisability ServicesDivorce CounselingDrug Abuse & Addiction InformationEmergency SheltersEmployee Training ServicesEthnic/Immigrant ServicesFamily CounselingFood BanksFood DistributionFood PantriesFunding OrganizationsGay / Lesbian ServicesGeneral Family ServicesGoodwill StoresGovernment Assistance ServicesGrant Making OrganizationsGrief CounselingGroup HomesGroup ResidentialHalfway HomesHalfway HousingHealthcare ClinicsHistorical SocietiesHomeless SheltersHorticultural SocietiesHospicesHousing for Retired ClergyHousing Support – Senior CitizensHuman Service OrganizationsJob Placement ServicesLearning Disorder ServicesLow Income HousingMarriage & Family CounselingMental Health ServicesMRDD Rehabilitation ServicesNeighborhood Multi Service CentersNutrition ProgramsOrphanagesOTHEROutreach ProgramsParenting EducationPastoral CounselingPregnancy Help CentersPrison Families Support ServicesPrivate FoundationsProfessional Societies, AssociationsPsychologist ServicesRape Counseling ServicesReading ProgramsReferral AgenciesRefugees & Settlement ServicesReligious OutreachRescue MissionsRescue MissionsSchool Social WorkSecond-Hand/Thrift StoresSelf-Help for AddictsSenior Activities Centers (Non Medical)Senior CentersSenior Independent LivingService LeaguesSettlement HousingSingle Parent Agencies / ServicesSleep Disorder CounselingSmoker’s Information & TreatmentSocial Service OrganizationsSoup KitchensSpeech TherapistsSpiritual CounselingStress Management ServicesSubsidized HousingSubstance Abuse Recovery (Post Detox)Support GroupsSupportive HousingTemporary HousingTemporary Relief ServicesThrift StoresTransitional HousingUnited Fund CouncilsUnited WayUnwed Mothers/Single ParentUrban LeaguesVictims of AbuseVocational Sheltered WorkshopsWomen’s Crisis ServicesWomen’s SheltersYMCAs/YWCAs, YMHAs/ YWHAsYouth CentersYouth ClubsYouth CounselingOther Business Type - please describe your operationsWhat are your estimated gross receipts?*You can estimate. If you are a new non profit, please write your estimate, because to obtain most quotes, an amount must inputted. Write in the amount of money that you bring in before the cost of your expenses.Describe your Operations - tell us what you do in detail (do not write your mission statement)*Please tell us what services you perform, OTHER THAN those listed in the drop down boxes above, if any. Use this space if you needed to tell us more information.Do you have a mission statement or vision statement to share?*You can paste the information above or write "no".What types of insurance are you seeking? General Liability Insurance Directors and Officers Insurance / EPLI for Non Profits Professional Liability (errors and omissions) Abuse and Molestation Coverage Property Insurance (buildings or equipment) Cyber Liability or Data Breach Workers Comp Commercial Auto Insurance Employment Practices Liability Insurance (EPLI) for a private company Employee Theft or Dishonesty Specific Items or Property Food Spoilage - coverage for food that spoils and needs to be replacedWe make it easy by asking you the only the questions for the coverages that you are requesting.What year was your group established?*How many employees do you have?*You can write "none" if you have do not have any.What is your annual payroll? ($)*If you have no payroll and only owners, please write none.Does a single client represent 50% or more of your business?*CHOOSE ONEYESNOTell 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?*CHOOSE ONENO - no claims in the last 5 yearsYES - there has been a claim in the last 5 yearsTell us About your Prior ClaimTAX ID / FEIN / SocialTo 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.How many square feet is the space that you occupy?Chose your Limits of LiabilityGeneral Liability*CHOOSE ONE$500,000 / $1,000,000$1,000,000 / $2,000,000$1,000,000 / $3,000,000$2,000,000 / $4,000,000I do not know what we want or needThese numbers are written as the per occurrence limit and the aggregate limit.Professional Liability - Errors and Omissions InsuranceCHOOSE ONEI do not know what we need or wantWe do not want this coverage$50,000 or less (available only for a few business types)$100,000$250,000$500,000$1,000,000$2,000,000$3,000,000$4,000,000$5,000,000This type of insurance is intended to protect you for claims that result from your professional services.Property Insurance SectionIn this section, you can choose how much coverage you want for your equipment, a building, glass, or other items.Do you own the building?CHOOSE ONENo - I do not own the buildingYes - I do own the buildingHow much coverage ($) 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 ($) for your business personal property?*This includes your furniture, inventory, printers, file cabinets, etc. We'll ask you about computers in the next box.How much coverage ($) 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)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 of the policy 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 guardCommercial Auto SectionDriver #1 - Provide the name and birthdate of at least 1 driverDriving Record for Driver #1CHOOSE ONEClean driving record - no tickets or accidents in last 5 yearsClean driving record - no tickets or accidents in last 3 years1 ticket or at-fault accident in last 3 years2 tickets or at-fault accidents in last 3 yearsMore than 2 tickets or at-fault accidents in last 3 yearsVehicle #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 equipmentExamples: 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?YesNoTell 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.Directors and Officers Insurance SectionHow many VOLUNTEER board members do you have?How many PAID board members do you have?Translator or Interpreter SectionDo you do simultaneous translation where 2 or more interpreters translate/interpret at once?Choose OneNone - we only interpret or translate directly with the client25% or less - use of simultaneous translation or interpretation26% - 49% use of simultaneous translation or interpretation50% or more - use of simultaneous translation or interpretationDo you do any translating for medical professionals?Choose OneNoYesWhat 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.Thrift Store or Consigment Store SectionDo you sell motorcycles, automobiles, children’s car seats, bunk beds, children’s, cribs, firearms or ammunition.CHOOSE ONENoYesn 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 shopThe last questions - finish your quoteCheck all of the following that apply to your Social Service or Non Profit Backgrounds checks are completed on all employees Backgrounds checks are completed on all volunteers Backgrounds checks WILL be done for abuse/molestation coverage We travel internationally We allow volunteers under 18 years of age We offer counseling services (such as family or alcohol) We run a day care Animal Shelter - we keep animals overnight at a fixed location Animal Fostering Services We have a Thrift Store We provide housing for people that we rent or ownMake sure to check all of the answers that apply to your non-profit.How many members are on your boad of directors?*Do you want to subscribe to our small business newsletter?Yes, pleaseNo, thank youWe do not send a lot of newsletters, but when we do, they are filled with valuable risk prevention and small business ideas.Δ