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Business/Employee Benefits Insurance Quote Request

Please provide as much information as possible in the form below. This information will be kept CONFIDENTIAL!

At Paige & Byrnes, we don’t think the notion of “instant quotes” serves anyone well. Instead, we’re committed to providing accurate quotes…so there won’t be any surprises later. But we won’t keep you waiting either. For a prompt, no obligation quote, please fill out the basic contact info below. One of our helpful agents will be in touch within a single business day to collect more pertinent coverage information and deliver your quote. Or if you’d prefer, you can call your local Paige & Byrnes office directly.

General Information
Name:
Address:
City: State: Zip:
We primarily serve clients in the Northeastern Ohio area.
Email: Phone Day:
Best time to call:   AM   PM Phone Night:

Current Insurance Company (not agency):
Company Name:
Policy Exp. Date:
 
/ /
 
What type of coverage's do you currently have:
Bond
Commercial Auto
Commercial Liability
Commercial Property
Commercial Umbrella
Disability
Group Health
Group Life
Professional Liability
Workers' Compensation
Directors & Officers Liability
Other  

About Your Business:
No. of full-time
employees
No. of part-time
employees
How long in
business
How many
locations
Annual
Sales
yrs. $

 
Please give a brief description of your business and clientele:

Additional Comments:
Please provide any additional comments below:

 

 

Thank you for taking the time to complete our form.  We will respond within one business day.

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