Business Name:    
Address:
City:
Florida
Zip Code:
Contact Name:
Phone #:    Ext #:
Fax:    Years in Business:
Email: (Required) 
Federal Employer's ID #:
Explanation of Business Operations:


Number of Employees:              
Payroll (not including owners): $
Estimated Gross Receipts:       $

Select all that apply to your Florida business:
Operate or lease aircraft/watercraft     Work Underground
Work above 15 feet                           Require out of state travel
Use Subcontractors                            Delivery Service
Pre-employment physicals                   Offer safety incentive programs
Store, treat, dispose, or transport hazardour waste
Work on vessels, docks, or bridges over water
Other

Recent Insurance Information:

Current Insurance Company: 
Policy #: Expiration Date: (mm/dd/yyyy)

What types of coverages do you currently have:
Benefit Liability               Business Liability
Commercial Umbrella     Directors & Officers Liability
Discrimination                 Errors & Omissions
Product Liability              Professional Liability
Other

Other Insurance Company Used In Last 3 Years: 
Policy #:
Losses past 3 years:     Amount paid for each loss: $
Explanation of losses, including amount paid on each accident:


Choose Florida Business Liability Insurance Limits:

General Aggregate Limit (other than products completed)   
Products/Completed Operations Aggregate Limit                
Umbrella Amount:

If you've already filled out information on your buildings or facilities
in another insurance quote form then skip the section below.


Building 1
Building Value: $   Inventory Value: $
Total Building Area:        Year Built:
Construction Type:          Sprinklers:
Electrical Type:                             Amps:
Electrical Renovation Year: 
Plumbing Renovation:     Plumbing Renovation Year:
Heating Type:               Heating Renovation Year:   
Roofing Renovation:       Roof Age (years):  
Central Alarm:

List Neighboring Businesses:
To the right:   Distance:
To the left:     Distance:
To the rear:    Distance:

Additional Information:


Click on the "Submit Quote Request" button below to send your
Florida Business Liability Insurance quote request.


**Information received from this Florida Business Liability Insurance quote request form sent to Optimal Insurance Group will be for our use only and will not be sold, given to or distributed to any other parties. A quote will be based on the Florida business liaiblity insurance information provided and does not guarantee acceptance of the risk by us. The precise coverage afforded is subject to meeting underwriting guidelines, and the terms, conditions and exclusions of the policy as issued. By submitting this request you acknowledge that this is neither an offer to insure nor a guarantee of insurance. Completion of this form does not entitle your business to a Florida Business Liability Insurance policy. We are licensed in Florida and will not provide business liability insurance quotes for other states.


Florida Business
Liability Insurance Quote
We can provide affordable Florida Business Liability Insurance
coverage in the Palm Beach County, Florida area!
Optimal Insurance Group
of Boca Raton, FL offers
comprehensive commercial
insurance coverage options
and affordable business
insurance services
throughout Florida.
Contact us about Florida
Group Health, Commercial
Auto, Commercial
Property, General Liability,
and Business Owners
Insurance at
(561) 342-1695.
In addition to Florida
Buisness Liability
Insurance quotes, we also
offer affordable Commercial
Auto Insurance quotes.
We are an independent Boca Raton, Florida insurance agency offering
business liability insurance premium quotes to mid-sized, large, and small
businesses in the following towns, cities and counties in south Florida:
Boynton Beach, Gulf Stream, Delray Beach, Lantana, Rainbow Lakes,
Atlantis, Lake Worth, South Palm Beach, Palm Springs, Greenacres,
Wellington, Haverhill, Palm Beach, Golden Lakes, Riviera Beach, Glen
Ridge, West Palm Beach, Lake Park, Royal Palm Beach, Jupiter, Coral
Springs, Fort Lauderdale, Parkland, Coconut Creek, Margate, North
Lauderdale, Lighthouse Point, Hillsboro Beach, Deerfield Beach, The
Hamptons, Highland Beach, Weston, Plantation, Playland Isles, Melrose
Park, Lauderhill, Sunrise, Tamarac, Wilton Manors, Oakland Park,
Lauderdale Lakes, Sea Ranch Lakes, Villages of Oriole, Pompano Beach,
Lauderdale-by-the-Sea, Boca West, Boca Pointe, Juno Beach, North Palm
Beach, Loxahatchee, Belle Glade, Palm Beach Shores, South Miami,
Cutler Ridge, Princeton, Perrine, Naranja, Homestead, Florida City, Leisure
City, Richmond Heights, Pinecrest, Howard, Coral Way Village,
Westchester, Westwood Lakes, Brownsville, Sweetwater, Key Biscayne,
North Bay Village, Miami Beach, Miami Springs, Virginia Gardens, Hialeah,
El Portal, Miami Shores, Medley, Indian Creek, Surfside, Bal Harbour, North
Miami, Biscayne Park, Pinewood Park, Opa Locka, Bunche Park, Hialeah
Gardens, Palm Springs North, Carol City, Norland, Ojus, Miami Lakes,
Biscayne Gardens, Hallandale, Sunny Isles Beach, Golden Beach,
Aventura, Uleta, Miramar, Pembroke Pines, North Miami Beach, Hallandale
Beach, Ives Estates, Pembroke Park, Coral Gables, Kendall, Dania Beach,
Cooper City, Davie, West Miami, Hollywood, Broward County, Martin
County, Miami-Dade County, and Palm Beach County, FL. We can also
offer affordable Florida business liability insurance quotes throughout the
Sunshine state, including in Winter Haven, Lakeland, Miami, Orlando,
Tampa, St. Petersburg, Tallahassee, and Jacksonville, FL.
Florida Business Information:
Your Florida Business
Liability Insurance Source
Optimal Insurance Group
4800 North Federal Hwy
Suite D-100
Boca Raton, Florida 33431
Palm Beach County FL
(561) 342-1695
Fax: 866-314-4026
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Florida Since 2002!
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