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"Insurance Experience California Residents & Businesses Can Count On!"
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10 Reasons Why You Should Use Adams Avenue Insurance Agency:

1. The best coverage at the lowest price.

2. Instant phone quotes for most products.

3. Low down payments.

4. Easy monthly installments.

5. Internet quotes returned within 24 business hours.

6. We have carriers that will insure houses with prior claims and that are in brush areas.

7. Rates are shopped exclusively for you with 25+ auto and home insurance companies.

8. Huge discounts on ALL insurance products!

9. Our experience allows us to match you with the carrier that best meets your needs.

10. We have been saving our customers money on insurance since 1988.


   
California business insurance

On-Line Business
Insurance Quote Form
One Simple Form - takes only 2-3 Minutes!


Your Personal / Company Data:

Your Name:
Your Company's Name:
Street Address:
City:
State: Must be California!
Zip/Postal:
E-Mail (REQUIRED):
E-Mail again for accuracy:
Phone:
Fax (optional):
 


Currently Insured?
(If yes, list carrier, and # of years
continuous. If none, type NONE)
 
List Claims & Amounts Paid
(If none, type NONE)
 
Years In Business:
 
Business type:
(proprietorship, corporation, etc.)
 
Your Social Security Number:
(Required for lowest rates/discounts)
 
Your Birthdate:
(Required for underwriting)
 
 


 
Underwriting Information:
 
Describe IN DETAIL,
Your Business Operations:
 
Ownership & Payroll Data:
List Employee's Annual Payroll Here (if none, enter $0): $ Insert # of
Employees here:
 
Location & Sales Information:
Insert Annual Gross Revenues from this operation here: $ Square Footage of office or business location:
 
Type of Building (wood frame, concrete, etc.): Number of Stories:
 
Are there other business/residences in this building (describe)?: Describe safety features (alarm, sprinklers, fire protection, etc):
 
Coverage Desired: (Check One Please)
The Coverage I Am Looking For:

Liability Only
Liability & Business Contents
Liability, Building & Contents Coverage
A Package Policy Including the Above,
        Plus Miscellaneous Coverages

NOTE: Don't worry if you are not exactly sure about coverage type... we will suggest the best coverage for you - just try to tell us what you are looking for! (If we need more info. we will let you know.)
 
Liability Coverage:
($300,000, $500,000, $1 Million, etc.)
$
 
Business Contents Coverage:
(The amount of your personal business property)
$
 
Building Coverage:
(The amount of building coverage if you own your bldg.)
$
 
Miscellaneous Coverage:
(List any special coverage peculiar to your business, such as Garagekeepers Legal, Loss of Earnings, Valuable Papers, etc.)
$
 
 
Send my quotation via: E-Mail Fax
Regular Mail
Please Call by Phone!

 
Thank you for filling out this form COMPLETELY!

We value your input as PRIVATE information. Every step has been taken to insure your privacy, security, and our intent is to release quote information only to you. We will not give your data to ANY other person or group for sales, marketing, or ANY other purposes. By checking the box below you agree to allow our agency to release this information via the method you have chosen, and to release us from any liability should this information be accidentally viewed by others. Our intention is to maintain your complete privacy.

Yes, I Agree. Please Send Me a
Business Owner's Quote NOW!

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Adams Avenue Insurance
19895 Beach Blvd., Suite 103
Huntington Beach, CA 92648
Phone: 1-714-593-1914 / Fax: 1-866-832-4186
E-Mail us at: dave@adamsaveins.com

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