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QUOTE REQUEST - Contact Information |
| Organization Name: |
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First Name: |
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Last Name: |
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Address: |
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City: |
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State: |
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Phone: |
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Zip Code: |
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E-mail: |
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Confirm E-mail: |
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| Website: |
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Gross
Receipts: |
(if you are a new business, please provide an
estimate) |
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| Annual Payroll
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(or write none) |
| Number of
Owners/Partners: |
(not employers) |
| Number of
Employees: |
(You can write none) |
| Year Business
Started: |
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| What percentage of your
business is: |
Translating (written):
Interpreting (spoken):
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| Do you do any translating
for medical professionals?
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Does more than 50% of your revenue come from a
single client? |
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Location: |
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| Do you do simultaneous
translation where 2 or more interpreters translate/interpret at
once? |
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| For what types of clients do you
translate or interpret? |
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Description of
Organization and your services.
What do you translate? What languages do you translate |
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Choose Your Limits of
Insurance |
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| Professional Liability
Insurance: |
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General Liability Insurance: |
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Types of
Insurance Requested: |
Other Options from which you can choose:
Workers
Compensation
Cyber
Liability (Data Breach Risk)
Employment
Practice Liability (EPLI)
Directors
and Officers (D&O)
Crime
Insurance
Surety
Bonds |
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Do you have any other information
about your business, or comments that you would like to
share? Please place special requests here. |
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Someone will contact you about your insurance request to go over the
coverage and options usually in the same day. |
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NO COVERAGE IS BOUND,
OFFERED, ISSUED THROUGH THIS ELECTRONIC COMMUNICATION, ALL POLICIES MUST BE
UNDERWRITTEN AND APPROVED BY THE CARRIER. DO NOT CANCEL YOUR CURRENT
INSURANCE.
Translator Insurance -
Interpreter Insurance - Deaf Interpreter Insurance
Copyright 2012 Stratum
Insurance Agency, LLC
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