GENERAL LIABILITY INSURANCE QUOTE We provide insurance coverage for Minnesota and Wisconsin only

To obtain a FREE, no obligation quote for General Liability, fill out the form below and we will contact you. In order to provide an accurate quote we would ask that you please provide us with the following information at the time of quoting. Information necessary to the quoting process may be collected from consumer reporting agencies, inspection services and motor vehicle departments. This information is available to the insurance companies who provide the quotes. *Required infomation Name: * Address: City: State: ZIP: Home Phone: * Email: * Work Phone: Cell Phone: Present Insurance Co: Renewal Date:    Own Home: Yes No Please provide a brief description of your business operations (daily tasks): If you are a logging entity please assist us by answering the following questions: Does the insured own, lease or operate a gravel pit? If yes are any products sold to others? Yes   No Yes   No Does the insured build roads for timber access? If yes is the insured responsible for locating or surveying the roads? Yes   No Yes   No Does the insured do any paving or concrete work? Yes   No Does the insured own, lease, or operate a sawmill? If yes what is the insured's finished product? Yes   No Does the insured do any residential tree removal, trimming or pruning? If yes approximate % of annual receipts received for tree service? Yes   No Does the insured employ any subcontractors? Are Certificates of insurance required from all subcontractors? What are the minimum liability limits required from the subcontractors? Yes   No Yes   No Please describe what the subcontractors are used for: What is the approximate number of people employed by the insured in each of the following areas? Please indicate fulltime and part-time employees with a total payroll per category also. Woods Equip Operators (skidders, fellerbunchers, etc)   Payroll Limbers (Employees working primarily with chain saws)   Payroll Truckers:   Payroll Approximate annual gross receipts prior to expenses for the business $ Comments:

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