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Peterson Insurance Services, Inc. is extremely pleased to be able to offer you the finest protection through Erie Insurance, an A+ rated carrier by A.M. Best. We have an impressive collection of property, casualty, and life products that can be tailored to meet your specific needs in today's business environment.
We offer all lines of business insurance at competitive rates:
Contractor's Insurance
Property and Liability Package Policies
Worker's Compensation
Business Catastrophe Liability (Commercial Umbrella)
Bonds
To receive more detailed information on our quality lines of business coverage or to request a quote, complete the form below and click the submit button. We will contact you promptly.
Name:
Address:
Name of Business:
Type of Business:
City:
Country:
State:
Pennsylvania
Home Telephone Number:
Work Telephone Number:
Cell Phone:
Fax Number:
Email Address:
Spouse's Name:
Social Security Number:
Years in Buisness :
Policy Period:
Business Entity::
Individual
Partnership
Corporation
Joint Venture
Other
Interest of Premises:
Owner
Service:
Office
Habitational
Program:
Retail
Wholesale
Service
Other
Habitational
Description of Operations:
Mortgagee name & addy:
LIMITS OF INSURANCE and OPTIONAL COVERAGES
Building:
Replacement Cost:
Actual Cash Value:
Construction:
Frame
Joisted Masonry
Masonry:
Noncombustible
Fire Resistive
Sq. foot area of each building:
Year of Construction:
Number of stories:
Business personal property:
Deductible:
$500
$1,000
$2,500
$5,000
$10,000
Exterior Glass:
Yes
No
Sign:
Yes
No
Money & Securities $10,000 Inside/$2,000 Outside
Systems breakdown/ boiler & machinery
Yes
No
Non-owned & Hired Automobile
Yes
No
Annual Sales:
Annual Payroll:
Accounts Receivable:
Valuable Papers:
Business Computer Hardware:
Business Computer Software:
Employee Dishonesty:
Business Liability:
Additional Insured Name and Address:
3 YEAR PRIOR CARRIER
Policy #1:
Expiration Date:
Premium:
Policy #2:
Expiration Date:
Premium:
Policy #3:
Expiration Date:
Premium:
LOSS HISTORY
Date of Loss:
Loss Descr.
Amount Paid:
Date of Loss:
Loss Descr.
Amount Paid:
Date of Loss:
Loss Descr.
Amount Paid:
REMARKS:
How Did You Hear About Us?
Quote requested within:
24hrs
48hrs
72hrs
120hrs
How do you want to recieve your quote?
Via E-mail
Fax
Telephone
Online Help Desk
Peterson Insurance Services, Inc.
Disclaimer
