Professional Risk Planners, Inc. - Insurance and Bonding Specialists Professional Risk Planners, Inc. - Insurance and Bonding Specialists Professional Risk Planners, Inc. - Insurance and Bonding Specialists
(631) 360-8800 Phone
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Protecting Your Business,
Your Lifestyle, and Your Employees

Professional Risk Planners, Inc. - Insurance and Bonding Specialists
Professional Risk Planners, Inc. - Insurance and Bonding Specialists
Professional Risk Planners, Inc. - Insurance and Bonding Specialists
Professional Risk Planners, Inc. - Insurance and Bonding Specialists
Professional Risk Planners, Inc. - Insurance and Bonding Specialists
Professional Risk Planners, Inc. - Insurance and Bonding Specialists
Professional Risk Planners, Inc. - Insurance and Bonding Specialists
Professional Risk Planners, Inc. - Insurance and Bonding Specialists

Workers' Compensation

Insurance Quote

We would like to provide you with a free, no-obligation Workers' Compensation insurance quote. Please provide as much information possible for the most accurate quote. This information will be kept confidential and will be used for quote purposes only.

General Information
Name of Business:
Contact Name:
Address:
City:   State:   Zip:
Business Status:     Other:
Business Tax ID Number:
Business Phone:   Fax:
Best Time To Call:   AM   PM
Contact Email Address:

Current Insurance Information
Company Name (not agency):
Policy Expiration Date:   Premium Amount: $
NCCI Number:
NCCI Experience Modification Number:
What type of coverages do you currently have:
Bond
Commercial Auto
Commercial Liability
Commercial Property
Commercial Umbrella
Directors & Officers Liability
Disability
Group Health
Group Life
Professional Liability
Other  

About Your Business
# of full-time
employees
# of part-time
employees
How long
in business
How many
locations
Estimated Annual
Payroll
years
$
Please give a brief description of your business(below):

Employee Information
Employee#
Classification Code or Job Description
Estimate Yearly Payroll
1
$
2
$
3
$
4
$
5
$
Please list additional employees in the "Additional Comments" section below

Business Information
Please select all that apply to Business:
Operate or Lease aircrafts/watercrafts
Store, treat, dispose or transport hazardous waste
Work Underground
Work above 15ft.
Work on vessels, docks or bridges over water
Require out of State travel
Use Subcontractors
Delievery Service
Pre-employment Physicals
Offer Safty and Incentive programs
Other  

Additional Comments
Please give any additional comments you feel appropriate for this quotation. If you have
additional information where there was not enough space, please enter them here.

Please click on the "Submit Quote" button to send your quote request.
One of our representatives will respond to your submission as soon as possible.

   


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Professional Risk Planners, Inc. - Insurance and Bonding Specialists
Professional Risk Planners, Inc.
670 Old Willets Path, Suite A
Hauppauge, New York 11788
Phone: 
Fax: 
(631)360-8800
(631)360-8875
ins@proriskplan.com

Professional Risk Planners, Inc. - Insurance and Bonding Specialists
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Important Note: This website provides only a simplified description of coverages and is not a statement of contract. Coverage may not apply in all states. For complete details of coverages, conditions, limits and losses not covered, be sure to read the policy, including all endorsements.

Professional Risk Planners, Inc. - Insurance and Bonding Specialists
Professional Risk Planners, Inc. - Insurance and Bonding Specialists

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Privacy Notice: Your privacy while visiting our website is important to us. Because there are parts of our site where we ask you to provide us with certain types of personal information about yourself, we want you to know how we will use it. We will use the information that you give us explicitly for the purposes stated on any online electronic form on this website, which in most cases will be for quoting, service, and information requests. We will not sell, share, or turn over any information you provide to any other person or organization. We may make it part of a reference source for future contact with you by our organization. We take your privacy very seriously, and ask that you contact us directly if you have any questions or concerns about the use of our website.