Call Us 559-320-2247
☰
˟
Call Us 559-320-2247
Agency License #0F00726
Our Agency
About
Employee Directory
Location(s)
Get A Quote
Our Providers
Quotes
Auto Quote Form (short)
Business & Commercial Insurance Quote Forms
Builders Risk
Commercial Auto Insurance Quote
General Liability Quote Form
Liquor Liability Quote Form
Workers Compensation Quote
Farm Quote Request
Flood Quote Request
Health Insurance Quote
Homeowners Insurance Quote
Life Insurance Quote
Products
Auto Insurance
Liability Coverage
Comprehensive Coverage
Collision Coverage
Uninsured & Underinsured Motorist Coverage
Specialty Auto Insurance
Home Insurance
Property Insurance
Homeowners Liability
Renters Insurance
Condo Insurance
Mobile Home Insurance
Scheduled Property Insurance
Other Personal Insurance
Identity Theft
Farm Insurance
Farm Owners Insurance
Farm Equipment Insurance
Farm Dwelling Insurance
Farm Structures Insurance
Farm Auto Insurance
Farm Umbrella Insurance
Farm Liability Insurance
Flood Insurance
Flood
Life Insurance
Individual Life Insurance
Group Life Insurance
Long-Term Care Insurance
Health Insurance
Individual & Family Health Insurance
Group Health Insurance
Dental Coverage
Vision Coverage
Supplemental Insurance
Prescription Insurance
HSAs
Recreational Vehicle Insurance
Boat Insurance
Motorcycle Insurance
Motorhome Insurance
ATV Insurance
Snowmobile Insurance
Coverage for Specific Industries
Construction Insurance
Specialty Trade Contractors Insurance
Financial Institution Insurance
Healthcare Facility Insurance
Healthcare Practice Insurance
Livestock Insurance
Maintenance Contractors Insurance
Media & Advertising Insurance
Pool & Spa Insurance
Real Estate Businesses Insurance
Self-Storage Insurance
Technology Services Insurance
Water Well Drillers Insurance
Coverage for Your Business
Workers Compensation
Professional Liability
Performance Bonds
Surety Bonds
Inland Marine Insurance
Builders Risk Insurance
Business Owners Policy (BOP)
Commercial General Liability
Commercial Auto Insurance
Commercial Property Insurance
Commercial Umbrella Insurance
Restaurant Insurance
Coverage for Your Employees
Employer-Sponsored Retirement
Group Benefits
Voluntary Benefits
Group Health Insurance
Disability Insurance
Individual Life Insurance
Contact Us
Home
>
Commercial-Products
>
Coverage-For-Your-Business
>
Contact Us
Name of Company
Address
Phone Number
Description of Operations (25 words or less)
FEIN or SS#
Name of Owners or Officers (Up to 4)
Contact Name & Number
Email Address
Class codes or types of work performed by employees and annual payroll for each
Type 1
Payroll
Number of Employees
Type 2
Payroll
Number of Employees
Type 3
Payroll
Number of Employees
Type 4
Payroll
Number of Employees
Type 5
Payroll
Number of Employees
Years of Workers Comp History
Annual Expiration Date
Valid Accurate quotes can only be provided with "paper" loss reports from your current and past workers comp companies, but we can give you a general idea of the cost
If you are a contractor, fill out your license number below. We can provide you with your past workers comp history and a letter or phone number to make it easier to request your loss history
Contractor License Number
If you have any questions reach out to Mark Rivard now!
Email at: mrivard@ccisinsurance.com
Call at: 559-320-2247