California Workers Compensation Insurance Quote from Adams Avenue Insurance Agency

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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.

On-Line Workers Compensation 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.)

Underwriting Information:

Describe IN DETAIL,
Your Business Operations:

Payroll Class #1:

List Class Code # if you know it, and describe payroll class: Insert Annual Payroll in dollars for this
class here: $

Payroll Class #2: (if none, leave blank)

List Class Code # if you know it, and describe payroll class: Insert Annual Payroll in dollars for this
class here: $

Payroll Class #3: (if none, leave blank)

List Class Code # if you know it, and describe payroll class: Insert Annual Payroll in dollars for this
class here: $

Send my quotation via: E-Mail Fax
Regular Mail

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Adams Avenue Insurance
9114 Adams Ave., Suite 144
Huntington Beach, CA 92646
Phone: 1-714-593-1914 / Fax: 1-866-832-4186
E-Mail us at: dave@adamsaveins.com