San Jose office
1225 West San Carlos
St San Jose CA 95126
(408) 491-1111
 
Fremont office
42132 Blacow Road
Fremont CA 94538
(510) 657-7777
 
(866) 755-2285
 
   
 
 
 
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Get Started - Business Insurance Quotes
KIS Insurance services, LLC makes shopping for business insurance easy. Fill out a short, easy form and license agent will contact you.
 
Business name:
Number of full-time employees:
Number of part-time employees:
Will this replace an existing business policy?
Yes No
Contact's First Name:
Contact's Last Name:
Business Street Address:
(No P.O. Boxes) Suite or Unit #:
City, State, ZIP Code:
Is the address above also the garaging address?
Yes No
SIC Code:
(SIC Code Finder)
Legal Entity/Status:
Number of Years in Business:
Gross Annual Payroll:
Gross Annual Revenue:
Years of Owner Experience within Industry:
Brief description of the business:
Desired Amount of General Liability Coverage:
Business Hours:
To Select Additional Coverage Types to Discuss with the Agent:
Non-owned Auto Coverage
Commercial Umbrella Coverage
Business Interruption Coverage
Business Street Address:
(No P.O. Boxes) Suite or Unit #:
City, State, ZIP Code:
Year Built or Last Updates Completed:
Construction Type:
Number of Stories:
Total Square Footage of Building:
sq. ft.
Square Footage of Space Occupied by this Business:
sq. ft.
Burglar Alarm Type:
Fire Alarm Type:
Desired Deductible Amount:
$
Physical Building Coverage Limit:
$
Business Personal Property Amount:
$
Additional Properties to Insure?
Yes No
Select Additional Coverage Types to Discuss with the Agent:
Non-owned Auto Coverage
Employment Practices Liability Coverag
Yes No
Do you have a safety program?
Yes No
Street Address of Garaging Location:
Suite or Unit #:
City, State, ZIP Code:
Number of Vehicles:
Number of Drivers:
Maximum distance traveled to a delivery or worksite:
Miles Desired Commercial Auto Liability Limit:
Desired Uninsured/Underinsured Motorist Limit:
Desired Deductible:
Select Additional Coverage Types to Discuss with the Agent:
Medical Coverage
Rental Reimbursement
Current Insurance Company:
Current Annual Premium:
Number of Claims in the Past 3 Years:
How many years has the business been continuously insured?
Desired Effective Date:
Business Street Address:
Suite or Unit #:
City, State, ZIP Code:
Contact's E-mail Address:
Contact's Phone Number
 
 
 
 
 
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