71 County St., Attleboro Massachusetts

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Commercial Insurance Quote Form
Providing Insurance Quotes in Attleboro, Massachusetts & surrounding area. 

Privacy Policy:  All information submitted to us via this web-site or via e-mail will be used exclusively by the Holman Insurance Agency, Inc. in order to provide quotes or service.  We will NOT provide your e-mail addresses to any other company or service for any other reason, and we will not use any information you provide in our other marketing programs.
Contractors, tradesmen & artisans, please click HERE for a quote from our specialty contractors program.
 
Business Name: Type of Business:
Contact Name:
Address
City State Zip
Phone
Fax
E-Mail
       
Type of Business    
Number of Owners/Partners:    
Number of Full Time Employees: Do not count owners/partners as employees as well. Only count employees OTHER than owner/partner.    
Number of Part Time Employees:    
Number of Years In Business*:    
*If startup operation, number of years principal has been in the industry?    
       
Do you currently have insurance:
 		 Yes    No 
 
If Yes, with which insurance company?
When does current policy expire?
Annual Premium:
List any losses (claims) in past 3 years:
       
       
Type of insurance interested in receiving a quote for:
Property Additional Comments:
General Liability
Business Auto
Workers' Compensation
Professional Liability
Tools & Equipment
Errors & Omissions Coverage

As every type of business requires specialized information to provide you with a quotation, 
you will be contacted by one of our agents.

TERMS & CONDITIONS:: Holman Insurance Agency, Inc. cannot bind, modify or cancel coverage via submissions to our website, or by messages sent through e-mail. Completion and submission of this form or e-mail does not constitute either a binder or an application for insurance. This site provides quotes and information only. An application signed by you and our agent is required for insurance to become effective.  .

Please submit only if you are seeking insurance in the Attleboro, Massachusetts or surrounding area.  If you're looking for an insurance quote from outside this area, you can find an Independent Agent in your area by clicking here


© Copyright, 2004 Holman Insurance Agency, Inc. (All rights reserved).