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  • About
    • Our Team
      • Elizabeth Culley
      • Jarel Culley
      • Susan Westlake
      • Jill Reil
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    • Business Insurance
      • General Liability Insurance
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      • Professional Liability Insurance
      • Commercial Umbrella Insurance
      • Business Auto Insurance
      • Flood Insurance
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      • Get Hawaii Business Insurance Quote
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    • Oregon Resources
      • Oregon Claims Resources
      • Get Oregon Home Insurance Quote
      • Get Oregon Auto Insurance Quote
      • Get Oregon Business Insurance Quote
  • Start Quotes Here
  • About
    • Our Team
      • Elizabeth Culley
      • Jarel Culley
      • Susan Westlake
      • Jill Reil
      • Join The Team
    • About Us
      • About
      • Contact Us
      • Reviews
      • Write a Google Review
    • More
      • Mortgagee Change Request
      • Community Involvement
      • Insurance in Maui Hawaii
      • Insurance in Bend Oregon
  • Services
    • Personal Insurance
      • Home Insurance
      • Auto Insurance
      • Renters Insurance
      • Life Insurance
      • Personal Umbrella Insurance
      • Rental Property Insurance
      • Course of Construction Insurance
      • Flood Insurance
      • Hurricane Insurance
      • Boat Insurance
    • Business Insurance
      • General Liability Insurance
      • Workers Compensation
      • Professional Liability Insurance
      • Commercial Umbrella Insurance
      • Business Auto Insurance
      • Flood Insurance
      • Inland Marine Insurance
      • Cyber Liability Insurance
    • Specialty Insurance
      • Condo Associations
      • Horse Mortality (Equine) Insurance
      • Special Event Insurance
      • Vacant Land Insurance Quote
  • Resources
    • General Resources
      • Corona Virus (COVID-19)
      • Insurance Companies
      • Mortgagee Change Request
      • Workers Comp Claim Forms
      • Frequently Asked Questions
      • Blog
    • Hawaii Resources
      • Hawaii Claims Resources
      • Condo Association Insurance
      • Get Hawaii Business Insurance Quote
      • Get Hawaii Home Insurance Quote
      • Get Hawaii Auto Insurance Quote
      • HO6 Condo Policy Uploader
    • Oregon Resources
      • Oregon Claims Resources
      • Get Oregon Home Insurance Quote
      • Get Oregon Auto Insurance Quote
      • Get Oregon Business Insurance Quote
  • Start Quotes Here

Business Insurance Quote

Step 1 of 23 - Insurance Type

0%
  • Thank you for your interest in receiving a business insurance quote. This form should only take about 5-10 minutes to complete. Don't worry if you don't have everything. You can always click the "Save and continue later" button below. We'll email you a private link to pick up where you left off.

  • Please LOGIN to use your profile information.

  • Check all that apply.
  • Date Format: MM slash DD slash YYYY
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  • Personal Information

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  • Business Information

  • If you do not have either, or operate using your Social Security Number, please enter "none".

  • This should be the physical address of your business. No PO Boxes please.

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  • Business Owners

  • (Click the "+" icon to add more owners)
    NameDate of BirthPhoneEmail% of Ownership 
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  • Vehicles

  • (Click the "+" icon to add more drivers)
    VIN NumberYearMakeModel 
  • Year Make Model VIN Actions
           
    • Edit
    • Delete
    There are no Vehicles.

    Maximum number of vehicles reached.

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  • Drivers

  • (Click the "+" icon to add more drivers)
    Driver NameDOB (mm/dd/yyyy)DL NumberDL State 
  • Include each driver's name and date of violation if possible.
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  • Business Information Continued

  • If you sell a product enter your total annual sales.

    If you provide a service enter your total business income.

  • Only for commission based businesses such as real estate, mortgage brokers, insurance agents, car dealerships, etc.
  • This is how much you pay your subcontractors, gross, per year.

  • Example: For contractors this could include roofing, plumbing, electrical, foundation pouring, etc.

    Example: For real estate brokers this would include your agents.

    Example: For janitorial this could include other cleaners, landscapers, etc.

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  • Building and Property Information

  • Accepted file types: pdf.
    PDF file type only.

    Its best for us to review the lease to make sure the insurance quotes are in accordance with your lease requirements. (Some leases require the tenant to insure the glass in the building, name the landlord as Additional Insured, and will list the required liability limits)

    This would be upgrades to the inside of your unit such as flooring, walls, built-ins, etc.

  • This is your office space, not the total square footage of the building.

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  • Additional Business Locations

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  • Building Information

  • If you are don't know when the roof was last updated just enter "unsure".

  • If you are don't know when the plumbing was last updated just enter "unsure".

  • If you are don't know when the electrical was last updated just enter "unsure".

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  • Business Description

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  • Customer Data

  • Examples include: Social security numbers, credit/debit cards, account number, health care records, personal information, etc.

  • • Acceptable Use Policy
    • Backup & Retention Policy
    • Data Security Policy
    • Incident Response Policy
    • Network Security Policy
    • Risk Assessment & Management Policy
    • SDLC & QA Policy
    • Third Party Security Policy

    If you don't have a security policy in place just enter "none".

    This also includes information which is on mobile devices, transmitted wirelessly, or transmitted over public networks, and encryption of non-employee full Social Security and full credit card numbers.

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  • Manufacturing

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  • Claims Information

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  • Current Insurance

  • You may upload copies of your current policies here.
    File types allowed: .pdf
    Each file maximum size: 5MB
    Maximum files: 10
    Drop files here or
    Accepted file types: pdf.
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  • Liability Limits (Optional)

    Example: Office equipment, computers, furniture, tools (that stay at the business location), or other items used for your business.

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  • Garage & Dealers Owners and Employees List

    This section requires the following information for all owners and employees: Name, Birthdate, Drivers License Number and License State, Employment Type (full or part time), and if the business provides the person with a vehicle.

  • Name Birthdate Drivers License # DL State Employment Type Actions
             
    • Edit
    • Delete
    There are no People.

    Maximum number of people reached.

  • We understand it may take some time to gather all this information. Please just be aware that we will need this information in order to submit to the insurance companies for a quote. Your agent will contact you to go over this.

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  • Garage & Dealers Information

  • Select all that apply
  • Example: If you have 20 vehicles at any one time and each vehicle has an average value of $25,000 then you would want $500,000 in coverage.
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  • Garage & Dealers Information

    List the percentage of the work you provide for each section below.

    Where work is performed. Total must equal 100%.
  • % at Your Shop
  • % at Customer's Location
  • % Other
  • 0%

  • Type(s) of work performed (in percent). Total must equal 100%.

  • % Body/Paint
  • % Brakes, Transmission or Suspension
  • % Electrical
  • % Mechanical
  • % Muffler/Radiator
  • % Oil Change
  • % Roadside Assistance
  • % Safety Inspection
  • % Tires/Wheels
  • % Tune Up
  • % Wash/Detail
  • % Welding
  • % Other (Upholstery, frame work, body work, window tint, windows, cleaning trailer, stereo system, etc.)
  • 0%

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  • Dealer Sales Questions

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  • Additional Insured Information (Optional)

  • You may upload your additional insured documents using the upload field below.
  • You may upload up to 10 PDF documents. If you have more documents you can send them to your agent after they contact you.
    Drop files here or
    Accepted file types: pdf.
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  • Additional Comments and/or Current Policy Upload (Optional)

  • You may upload up to 5 additional PDF documents here.
    If a file is over 8MB please email to us at [email protected]
    Drop files here or
    Accepted file types: pdf.
Save and Continue Later
  • Wrapping Up

  • Like most insurance agencies, Culley Insurance Group uses information from you and other sources, such as your driving and claims histories, insurance score, and other factors to calculate an accurate rate for your insurance. New or updated information may be used to calculate your renewal premium.
  • Strength indicator
  • This field is for validation purposes and should be left unchanged.
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Get A Quote

  • Homeowners Quote
  • Auto Insurance Quote
  • Rental Property Quote
  • Course of Construction Quote
  • Life Insurance Quote
  • Renters Insurance Quote
  • Business Insurance Quote
  • Flood Insurance Quote
  • Condo Association Quote
  • Equine Insurance Quote
  • Watercraft Insurance Quote
  • Vacant Land Insurance Quote

Personal Insurance

  • Auto Insurance
  • Home Insurance
  • Life Insurance
  • Renters Insurance
  • Flood Insurance
  • Hurricane Insurance
  • Rental Property Insurance
  • Special Event Insurance

Business Insurance

  • General Liability Insurance
  • Professional Liability Insurance
  • Workers Compensation
  • Business Auto Insurance
  • Commercial Umbrella
  • Inland Marine Insurance
  • Flood Insurance

Specialty Insurance

  • Condominium Associations
  • Cyber Liability Insurance
  • Horse Mortality Insurance
  • Special Event Insurance
  • Vacant Land Insurance

Resources

  • COVID-19: Latest Updates
  • Insurance Companies
  • Blog

For Clients

  • Client Center
  • Make A Payment
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  • Write a Google Review
  • Mortgagee Change Request
  • HO6 Condo Policy Upload

Locations

  • Maui, Hawaii
  • Bend, Oregon
Culley Insurance GroupHawaii Mailing Address: PO Box 1827, Kihei HI, 96753 • (808) 419-7099
Culley Insurance GroupOregon Mailing Address: PO Box 7258, Bend OR, 97708 • (541) 550-7075
Fax: 808-879-2370
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