insurance graphic

You may just want to change agents - Check with us before you buy or renew!

insurance graphic

Low Cost
Insurance for
North Carolina
Residents!


Call Us for a
RUSH Quote.
We can place
Coverage
INSTANTLY!

 
Or, Get A FREE
Quote On-Line

 
 
Auto Insurance
"D.W.I." Insurance
Antique & Classic Car
Cycle & 4 Wheeler
Homeowners
Builder's Risk
Modular/MobileHome
Businessowners
Worker's Comp
Commercial Auto
Contractor Liability
Recreational Vehicle
Boat Insurance
Life Insurance
Short Term Health
Hospital Insurance
Medicare Supplements
Disability Insurance

 
Contact Us
 
 
E-Mail:
apbenfield@aol.com

Phone:
Toll Free:
1-866-632-6458
Direct Line:
1-828-632-6505

Fax:
1-828-632-0172

Mailing Address:
78 East Main
Avenue
Taylorsville,
NC 28681

Insurance
License #:

237-68-0393

Meet Our Staff!


For Your
Convenience,
We Accept:

Don't forget to ask about our "10+10" Insurance Discount! That's 10% off your Home and Auto Insurance when we write both policies. DOUBLE Your Discounts NOW!

insurance
 
 

On-Line Contractor
General Liability Quote Form
One Simple Form - takes only 2-3 Minutes!

Your Name:
BUSINESS Name:
Mailing Address:
City:
State: (Must be North Carolina)
Zip/Postal:
E-Mail (REQUIRED):
E-Mail again for accuracy:
Phone:
Fax (optional):
 
Business Underwriting Information
Type of operation:
Describe operations in detail:
License class:
License Number:
 
Limit of Liability
Coverage Requested?
$300,000
$500,000
$1 Million
 
Currently Insured? Yes No
Name of Carrier & how long insured?
Prior Claims? Yes No
Describe claims in detail:
 
Years in business:
Years experience in field:
Percentage of work residential:
Percentage of work commercial:
 
Number of Active Owners:
Number of Employees: 0   1   2   3+
Annual Employee Payroll: $
Annual Gross Sales: $
 
Do you subcontract work? Yes No
(If yes, what percentage of your work
is subbed, and what kind of work?)
Do you do foundation work? Yes No
Do you work on condos? Yes No
Employees paid over $18/hour? Yes No
Do you have a safety program? Yes No

 
Comments/Remarks:
 
Send my quotation via: E-Mail Fax
Regular Mail
Please Call Me!


Thank you for filling out this form COMPLETELY!

We value your input as PRIVATE information. Every step has been taken to insure your privacy, security, and our intent is to release quote information only to you. We will not give your data to ANY other person or group for sales, marketing, or ANY other purposes. By checking the box below you agree to allow our agency to release this information via the method you have chosen, and to release them from any liability should this information be accidentally viewed by others. Our intention is to maintain your complete privacy.

Yes, I Agree. Please Send Me a Quote NOW!


Help Us Fight Spam! Type the Numerical Code you see at right, into the empty text box on the left, so we know you are a human. Thanks for your help!

Enter code at right, here:
Web Form Protection Code
reload image

Click Button Below When Done

Please Click Only Once . . . May take up to 30 seconds!

 
Terms of Use/Privacy Notice/Copyright Info. No. Carolina Insurance Online since: September 2,000.
Please report site-related technical problems to: apbenfield@aol.com    2008 Insurance-Web-Sales
 
insurance graphic