Powers & Company : Contractor Liability, Worker's Compensation, Auto Insurance.

Powers & Company is one of the fastest growing insurance brokers in California. Since 1992, we have specialized in servicing the Construction industry for their insurance needs. Because of our commitment to providing great value and service, we insure approximately 1 in 10 insured contractors in California. Our team of trained and dedicated Agents and Customer Service Agents are ready to assist you with your insurance needs. Our agents average over 15 years of contractor insurance experience. This knowledge and experience, along with the business partnerships we have with a wide variety of carriers, enable Powers & Company to obtain the coverage that best fits your needs at the highest value. Once your coverage is in effect, our highly trained customer service representatives will provide you excellent service throughout the year. You have our Superior Service Guarantee.

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Disclaimer: Insurance transactions are NOT effective without
acknowledgement from a Powers & Company Representative.
All quotes subject to final underwriter/carrier approval.

Items marked with * are required to process this form correctly.

*Contractor License Number:

*Business Name:

*Business Address:

*City:

*State:	CA

*Zip:

*Owner/Contact Name:

*Number of Active Owners:

*Business Phone:

Mobile Phone:

Business Fax:

*Business Email:

*Estimated Gross Annual Receipts:	$

*Estimated Annual Field Payroll:	$

*Estimated Annual Sub-Out Cost:	$


*Liability Limit:	$300,000/$500,000 $500,000/$1,000,000 $1,000,000/$1,000,000 $1,000,000/$2,000,000

*Claims in the Last Three Years?:	Yes No

*Years Continuous Liability Coverage:	0 1 2 3

Current Insurance Carrier:

Policy Expiration Date:

*Number of Years in Business:

*Type of Work You Do:

*How Did You Find Us?	Flyer in the mail Faxed flyer Online search Referral Other (If checked, please specify:

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